Page 140 - Impact of implant retained overdenture treatment and speech, oromyofunction, social participation and quality of life.

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Chapter 6
In the transition from a CD with palatal coverage (which comprises the oral space in vertical dimension) to an IOD (implant retained overdenture) without palatal plate (which comprises the oral space in horizontal dimension), the tongue needs to find the proper contact places and referential points to be able to mold the airstream in the same way as before. In the majority of the participants this is no problem. Still some participants suffered from problems producing the /s/ sound. These results were found in paper 2 (n: 6/16, 37.5% suffered from /s/ problem) and paper 3 (n: 9/25, 36%).
Because of the remaining articulation problems when converting from CD to the IOD (paper 2&3), we can conclude that removing the palatal coverage along with better retention and stability of the denture, does not solve all articulation disorders.
The 3 year follow up research on maxillary overdentures (paper 2) revealed that even after this period, still a great portion of the patients (n: 6/16, 37.5%), suffer from a distorted /s/ sound 66. This is also shown in previous studies on maxillary FID (fixed implant denture) and IOD treatments. The results of our measurements of satisfaction and OHRQoL show that this doesn’t necessarily mean that patients complain about their speech. It is important to notice that there can be discrepancies between the internal standard of professional SLP’s compared to non-professionals. The internal standard of a listener is an unstable set of phonetic benchmarks based on previously perceived samples. These standards represent typical examples for normal and deviated speech. The standard of an SLP is different than that of an average person. We didn’t rate the grade of this distortion. It is possible that the distortion improved over time, but doesn’t meet the standard of the SLPs 67.
In 2021 a systematic review about speech in implant supported and removable complete denture wearers, by Meira et al. (2021), was published. Their aim was to examine the influence of IOD, FIDs and CDs on speech in patients with at least one completely edentulous jaw. Out of initially 2586 articles, only 9 were selected. Only full-length reports of observational and experimental clinical studies were considered. The risk of bias of the individual studies was evaluated by two researchers, using the Joanna Briggs Institute checklists for quasi-experimental and cross-sectional studies 43. One study of the current