Page 119 - Impact of implant retained overdenture treatment and speech, oromyofunction, social participation and quality of life.

Personality, social participation and OHRQoL in dental implant treatment
Introduction
Life expectancy is rising and hence patients will keep their natural teeth longer and functional. Nevertheless, large numbers of patients are edentulous and in need of wearing dentures. According to Johannsen et al (2012) tooth loss leads to fear, shame and denial affecting patient’s social activities 1. Edentulism can be seen as a chronic disease which requests treatment according to the International Classification of Functioning, Disability and Health (ICF) 2. In this framework, the outcome of a treatment is described in terms of three main components: Body functions and structures, activity and participation. These three components are in interaction with the health condition, personal factors (including personality) and environmental factors 2. In the evaluation of any treatment it is important to keep these factors and interactions in mind. Social participation may, according to the ICF, contribute to the feeling of quality of life. Edentulism is not only associated with less oral functionality, but also with loss of social status and less self-esteem. It is hence important and necessary to take all these impacts into account while evaluating the result of dental treatments 3.
Compared to a natural dentition, denture wearing is associated with a reduction in functional comfort and oral health related quality of life. A dental prostheses aims to restore speech, chewing, bite and swallow functions, but also improves aesthetics and facilitate psychosocial functions 4,5. Lack of stability and retention as well as decreased chewing ability are the most prevalent patient complaints 4. Dental implants are useful to replace missing teeth or to improve denture stability. As such, an overdenture retained on two dental implants in the lower jaw has been suggested as the minimal standard of care to improve denture retention 6, improve social life and increase self-esteem due to the restored chewing function and improved aesthetics 1.
Quality of life after dental treatments has been substantively investigated the past years 7, examining the influence of edentulism on various domains such as speech and chewing functions, but also aesthetics, self-confidence, different psychological and social factors 8. The outcome is influenced by gender, age and educational level of the patient. Chen et al (2012), for example, investigated 102 patients with a single unit implant treatment, and showed a
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