Page 139 - Impact of implant retained overdenture treatment and speech, oromyofunction, social participation and quality of life.

improved retention of the denture, affect the way the tongue is positioned in the mouth to produce the speech sounds. This possible influence can be both positive (improved retention) and negative (difficulties in tongue movement and positioning to shape the airstream into speech sounds). In light of this it is very important that the surgeon and the dentist collaborate to provide the least possible harm for the patient. Proper implant placement to ensure that the attachment system can be placed within the normal denture size is essential and may overcome many phonetic issues. In addition it adds to proper axial loading of the implant, simplifies the prosthetic procedure, reduces technical complications and facilitates peri-implant maintenance.
Influence of overdenture treatment on speech
The first objective of this thesis was to assess prospectively the influence of changes made to the oral environment during overdenture treatment on speech.
The evaluation of speech was performed using a picture naming test, evaluated by two SLPs. Rater 1 wasn’t blinded. Rater 1 and rater 2 evaluated the speech samples independently. Afterwards the results were compared and differences were discussed until consensus was reached. The interrater reliability score was computed on the initial ratings of both SLPs before discussion.
Speech sounds are the result of the delicate interaction of the speech structures and the air stream. It was concluded that articulation errors occurred in all stages of the treatment in the mandible and the maxilla (paper 1-3) but there were no significant differences between the stages. Studies on speech in dental rehabilitation in the maxilla report distortions in /s/, /z/, /t/, /d/,/n/, /l/, /r/, /v/ and /f/ sounds11,24,25,27,28,65. We can confirm the occurrence of difficulties with the /s/, /z/, /t/, /d/, /n/ and /l/ sounds, supplemented with minor problems in producing the / ʃ/ and the / ʒ/. The /s/ sound in particular is sensitive to changes in the oral cavity as it is produced with the tongue tip close to the upper or lower aveolar ridge. This is a well-known articulation disorder in dental rehabilitation. After connection of the overdenture, both in the mandible and the maxilla, still a percentage of the patients suffered from speech difficulties, especially with the /s/ sound (table 1).
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General discussion and future considerations
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