Page 71 - Impact of implant retained overdenture treatment and speech, oromyofunction, social participation and quality of life.

Speech and OHRQoL in OD treatment in the maxilla
Introduction
The elderly population is growing worldwide and edentulism increased with 27% between 2006 and 2016.2 Edentulism is closely related to socioeconomic factors and has a negative impact on both oral and general health.3 Large proportions of edentulous patients wear conventional removable dentures (CD), which imply some negative side-effects. These include residual ridge resorption yielding limited mastication and unhealthy food selection as well as negative effects on day-to-day activities. Hence, edentulous patients report poorer oral health-related quality of life (OHRQoL) related to dysfunctional mastication, lower self-esteem and aesthetic concerns.3,4 The use of dental implants can prevent bone loss of the ridge.5 But studies indicate improved quality of life and masticatory function when treated with an IOD and therefore this is a more cost-effective treatment than CD.6
For edentulous mandibles, treatment with IODs on two implants is the standard of care according to the McGill consensus statement.7 For the edentulous maxilla, there is currently no consensus on what is the best treatment option. However, it is well established that treatment with a four or six implant IOD yields good clinical results in patients with denture retention issues in the maxilla.8,9 The review of Di Francesco and co-workers (2019) describes a survival ranging from 73.5% to 100% for maxillary implants and 87.5% to 100% for the maxillary denture connecting to the implants. They found a correlation between the number of installed implants and the survival rate. A minimum of four implants, whether or not connected with a bar, effects the outcome positively.10
Besides the technical demands to establish whether an implant treatment is successful, the impact of oral health on quality of life is important. Poor oral health has a negative influence on the quality of life and is an important part of public health.11 OHRQoL includes the functional, social and psychological effects of oral diseases on the individual.12 OHRQoL can be measured by means of the validated Oral Health Impact Profile (OHIP).13 The shortened version of the Oral Health Impact Profile, the OHIP-14,14 is currently one of the most used standardized questionnaires in the dental practice.8 Besides the OHIP-14 to measure OHRQoL, questions using a visual analogue scale (VAS), are preferred to assess patients’ satisfaction.15 Michaud et al. (2012) concluded that there is a positive correlation
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