Page 109 - Impact of implant retained overdenture treatment and speech, oromyofunction, social participation and quality of life.

Speech, OMF and OHRQoL in OD on MDI in the maxilla
Discussion
Speech sounds are the result of delicate interaction of the speech structures and the air stream. The air stream gets well-adjusted by the position of the speech structures and produces the sounds we know as speech sounds. It is known that changes to these structures, as is the case in dental rehabilitation, can cause difficulties in speech production. In this study a horse-shoe implant overdenture design was used. The bucco-lingual dimension of this prosthesis is slightly wider than fixed dentures to allow space for the housing of the attachment system. Pretreatment, patients who were unsatisfied with their removable denture came for treatment and were included in this study. Patients included in this study were referred with retention problems of their existing removable prosthesis. Hence it is reasonable to accept that the speech therapist revealed several problems. Bothur and Garsten (2010) stated that patients’ subjective experiences of speech may vary and patients who were previously accustomed to a well fitted conventional denture are not presenting with many speech problems.30 However, patients with less retention of their denture present with poor speech and poor satisfaction. Their study did not describe in detail the speech problems that occurred. The speech problems reported in our study are similar, yet not completely in agreement to the ones reported in previous studies on conventional removable dentures in the maxilla. In those studies problems with /s/, /z/, /l/ and /t/ are reported.14, 12 This difference can be due to the fact that in our study the conventional removable dentures were inadequate and not perfect as compared to participants with well fitted and adapted dentures in other studies. Especially because the conventional dentures covered the palate and had unsatisfying retention, the outcome on speech, oromyofunction and satisfaction were rated negatively prior to treatment.7
After surgery the prosthesis was adjusted and relined which resulted in less speech problems. It is understandable that the relining of the prosthesis over the implants, led to this improvement of speech. The nature of those distortions is not fully understood and it seems to be reasonable to assume that bad retention may have an impact. Especially the modification in the palatal coverage during the treatment procedure is to be considered as an additional factor affecting speech. The relined dentures covered the palate of the participants. As seen in
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