Page 45 - Impact of implant retained overdenture treatment and speech, oromyofunction, social participation and quality of life.

Speech, OMF and OHRQoL in OD treatment in the mandible
Introduction
When adjustments are made to the orofacial and dental structures, the possible impact on different functions and quality of life can’t be underestimated. Despite more attention for oral health care, a substantial part of the population is still confronted with loss of all teeth, in most instances because life expectancy is rising.1 On the other hand, people have higher demands and expectations regarding aesthetics, comfort and function.2 In many cases removable appliances are the first choice predominantly dependent of the financial condition of the patient. Unfortunately denture wearing reduces functional comfort when compared to natural teeth and affects oral health related quality of life (OHRQoL). 3,4
In fully edentulous patients, the first choice of rehabilitation is by means of a conventional removable denture. Over time, the wearing of a conventional denture worsens bone resorption and consequently decreases functionality.3 Lack of stability and retention of the conventional denture is the most prevalent patient complaint and causes reduced chewing ability and reduced comfort during articulation.5 To improve denture retention, dental implants are useful and overdentures on two implants in the lower jaw are considered the minimal standard of care.6,7 For the majority of the edentulous patients, a 2-4 mandibular implant overdenture delivers a sufficient treatment solution with 95% implant survival after 10 years.8 The most common way to anchor a dental prosthesis is a treatment with conventional dental implants of at least 3.5 mm diameter. Eating comfort, speech and aesthetics are known to be the most important factors in determining oral health related quality of life after dental rehabilitation.9,10
Speech is the result of a complex interaction between the respiratory system (lungs), phonatory system (vocal folds), resonatory system (pharynx, nasal and oral cavity) and the articulatory system (the jaw, tongue, lips, soft palate, teeth, hard palate and the alveolar ridge).11 Air from the lungs passes through the pharynx, larynx and oronasal cavity during exhalation. The movable structures in the oral cavity (tongue, uvula, lips and jaw) are able to take specific positions, molding the air stream and causing sounds we know as speech sounds. The latter is called articulation.11 When changes are made to those structures, as is the case in rehabilitation with full dentures, it is possible that this complex
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