Page 21 - Impact of implant retained overdenture treatment and speech, oromyofunction, social participation and quality of life.

and benefit more from minimally invasive surgery. In light of this evolution, one piece mini-dental implants (MDI) with diameter less than or equal to 2.5mm should be considered as an alternative treatment solution for improved denture retention 18,19.
Treatment with MDI is introduced early 2000 and in general its outcome is promising although the clinical outcome defined by implant survival, bone stability or complications is often underreported, especially in the upper jaw 18,20.
Speech in rehabilitation of the edentulous jaw
Speech is the result of a complex interaction between the respiratory system (lungs), phonatory system (vocal folds), resonatory system (pharynx, nasal and oral cavity) and the articulatory system (the jaw, tongue, lips, soft palate, teeth, hard palate and the alveolar ridge) 21. Air from the lungs passes through the pharynx, larynx and oronasal cavity during exhalation. The movable structures in the oral cavity (tongue, velopharyngeal mechanism, lips and jaw) are able to take specific positions, molding the air stream and causing sounds we know as speech sounds. This process is called articulation 21. When changes are made to the oral structures, as is the case in rehabilitation with full dentures, it is possible that this complex interaction is disturbed and articulation in speech production is affected (Fig. 4). Table 1 gives an overview of the relevant literature concerning speech and oromyofunctional behavior in the rehabilitation of the edentulous jaw.
Traditionally, consonants are described according to place (where along the vocal tract the consonant is formed; e.g. bilabial, alveolar, velar, palatal,...), manner (how is it formed; e.g. nasa, glide, fricative,...) and voicing (whether the vocal folds are vibrating during production). Articulation disorders can be categorized into omissions (the sound is not produced), substitutions (the sound is replaced by another sound), additions (another sound is added to the target sound) or distortions (the sound is produced in an alternative way) 23. There are two main causes of articulation problems. Firstly, functional problems caused by a wrong use of the articulatory muscles. Secondly, organic problems which appear due to changes of the structures responsible for articulation, which is the case in dental rehabilitation 21. Studies on speech in dental rehabilitation in the maxilla report distortions in alveolar sounds (/s/, /z/, /t/, /d/,/n/, /l/ and
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Introduction
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