Page 63 - 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
with the /t/ sound when treated in the mandible. Research by Sansone et al. and Heydecke et al. reported no influence of the treatment in the mandible on articulation.17,24 The fact that we assessed no significant changes and previous studies reported no problems, indicate no impact of mandibular overdenture treatment on articulation in speech. This needs to be assessed in a bigger study population to be able to generalize this statement.
The second domain we examined was oromyofunctional behavior. There was no significant difference between de stages of the treatment. Still there were several patients presenting problems with oromyofunction. This is not in line with the few previous articles on fixed dentures in the mandible.12,15 The study of Van Lierde et al. and the study of Jacobs et al. revealed no oromyofunctional disorders in patients with fixed dentures, overdentures and conventional dentures. Six of the 25 items tested were detected as distorted at some point during treatment. It is important to notice that the percentage of all disorders decreased during treatment. Only difficulties in whistling increased clinically in the last stage. It is important to know that in 5 of the 6 patients presenting whistling problems, this was the only oromyofunctional problem. Given this information, one can question the relevance of being able to whistle.
The third domain was satisfaction and OHRQoL. The results of the OHIP and the VAS scales revealed an improvement of satisfaction with oral health and satisfaction with speech. This is in line with previous research on fixed dentures and overdentures in the mandible.35 Despite the considerably high percentage of patients with speech problems in the final stage of the treatment, the satisfaction with speech is high. It is possible that when patients rate their speech on the VAS and the OHIP-14 form, they consider both their production of the sounds and their comfort of speaking in the evaluation. The latter is an aspect of speech, speech-language pathologists cannot observe and cannot rate. Therefore, it is very important to ask the patients opinion about the outcome of the treatment before giving a professional evaluation of their functioning. Besides the general improvement of satisfaction with oral health and OHRQoL during treatment, the results after provisionalisation of the denture slightly drop. Hypothetically one can assume that patients expect the biggest improvement after surgery, and when this improvement is not what
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