Page 159 - Impact of implant retained overdenture treatment and speech, oromyofunction, social participation and quality of life.

Summary and social relevance
Conclusion: There was a minor impact of treatment with single crowns on quality of life and social participation compared to the full denture group. The role of personality and the use of multi-informants in evaluating dental treatment was found important.
Based on the proposed aims, the following general conclusions and future considerations can be formulated:
1. Articulation errors occur in all stages of the treatment in the maxilla and the mandibula but there were no significant differences between the stages. 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 alveolar ridge. Even after 3 years adaptation, still a great portion of the patients suffered from a distorted /s/ sound. Future research should focus on how to deal with patients with remaining speech problems. Possibly the shape of de denture can be adjusted to provide better tongue mobility or the focus needs to be on speech therapy.
2. The studies revealed, in contrast with existing literature, the occurrence of oromyofunctional problems in all stages of the treatments. There were no significant differences between the stages.
3. Ourresultsshowedanimprovementofsatisfactionwithoralhealth and speech and a lower impact on quality of life after treatment was completed. In contrast with the high rate on speech satisfaction the occurrence of speech problems is high. Given this, it is particularly important for professionals to ask patients opinion about the outcome of the treatment before giving an evaluation of their functioning. During treatment the ratings vary. It is important to give patients a good view on how the treatment will evolve, to make sure the expectations of the treatment are realistic.
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