Page 64 - Impact of implant retained overdenture treatment and speech, oromyofunction, social participation and quality of life.

62
Chapter 2
they hoped for, patients may be disappointed. This underlines the importance of providing good information to the patient before treatment.
It is worth noticing that the strength of this study lies in the evaluation of articulation and oromyofunction by two independent professional speech- language pathologists and the extensive protocol used to evaluate the patients. Moreover, this is the first study in the Flemish language (Dutch spoken in the northern part of Belgium) assessing the impact of implant-retained overdentures in the mandible on articulation. This method is reliable but can be improved, especially because the /s/ sound turned out to be our primary affected sound and the interrater reliability of the two SLPs was acceptable but not excellent. The longitudinal, prospective design of this study is of great value but also caused drop-out due to organizational and logistic issues. Due to this drop out the post hoc power of the statistical results doesn’t meet the ideal 0.80. Future research should focus on larger samples to generate robust statistical results. Still it is for this kind of research with a specific kind of treatment in this kind of population (higher age) a great challenge to organize this. Collaboration of different institutes or enrollment of patients in the study for several consecutive years would be needed. Finally, it is also possible that patients already had some articulation errors during their lifetime. This is impossible to assess because our participants came to the clinic with an existing denture, already influencing articulation and oromyofunctional behavior.
How the remaining articulation errors and oromyofunctional problems can be solved is another research question. It might be needed to adjust the width of the denture to allow the tongue to move properly in the oral cavity to produce correct sounds. This was already suggested by Collaert et al. in fixed dentures in the maxilla. 21 Besides that, articulation therapy could be a solution worth investigating.
Conclusion
In patients, treated with mandibular bar retained overdenture on two implants, oromyofunctional and articulation disorders were assessed in all stages of the treatment. The results of this study reveal no statistically significant changes