Page 53 - 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
Satisfaction and quality of life
Prior to each examination, patients filled in the validated Dutch version of the shortened Oral Health Impact Profile (OHIP-14, Slade and Spencer 1994 32, van der Meulen et al. 2008 33). The OHIP-14 consists of 14 items divided in 7 domains: 1. functional limitation; 2. physical pain; 3. psychological discomfort; 4. physical disability; 5. psychological disability; 6. social disability and 7. handicap. We used the first question (Have you had trouble pronouncing any words because of problems with your teeth, mouth, dentures or jaw?) to determine the impact of the treatment on articulation and the total OHIP-14 score to measure the Oral Health related Quality of life. The items were rated by a Likert-scale ranging from 0 (no discomfort) to 4 (high discomfort). A total OHIP-14 score was assessed by counting the scores of the 14 individuals questions. A score of 56/56 is indicative for maximal negative appreciation and 0/56 indicates that there are no issues at all. Additionally, two visual analog scales (VAS, 10 cm) were used to rate the patient’s satisfaction with speech and general oral health at each experimental interval. In the visual analog scales, the end of the line reflects 100% maximal satisfaction and the other end of the line corresponds 0% to complete dissatisfaction.
Statistical Analysis
To compare the changes in the variables of at least interval scale (number of errors per person, spectral characteristics and scores for satisfaction and OHRQoL) between the different stages of the treatment a Wilcoxon matched- pairs signed-rank-test was used. To compare the changes over time in the variables of a nominal scale (type of articulation and oromyofunctional errors) a McNemar test was used. The difference in speech outcomes between the ‘disturbed hearing’ group and the ‘normal hearing’ group (results based on a questionnaire) was assessed using a Mann-Whitney-U test. We estimated interrater reliability using Cohen’s Kappa. Interpretation of these levels happened according to Landis and Koch.29 All levels of significance were set at α=0.05/3 (=0.01667), according to the Bonferroni correction for multiple testing. For analysis of the data SPSS statistics 25 (IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp) was used.
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