Page 72 - Impact of implant retained overdenture treatment and speech, oromyofunction, social participation and quality of life.

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Chapter 3
between denture satisfaction and OHRQoL, specially satisfaction with the oral condition and chewing ability are key parameters.12 The OHRQoL in maxillary CD is broadly described in literature. The review of Thalji et al. (2016) concluded that the expectations of patients regarding aesthetic and phonetic rehabilitation are high and can be met using CDs in the maxilla. Although when patients are dissatisfied an alternative implant treatment can be the solution.16
There is plenty of evidence for improved OHRQoL with IODs in the mandible but for the maxillary IOD literature is scarce.17 Various studies reported a higher satisfaction8,17 and an improved OHRQoL18,19 in patients treated with maxillary IODs compared to CD. Maxillary Fixed implant Dentures (FID) and IODs were compared within-patient by Heydecke and co-workers (2003). They demonstrate that patients’ general satisfaction, their ability to speak and the easiness for cleaning the prosthesis is higher when treated with removable long-bar IODs.20 Studies show a significant increase of OHRQoL in patients treated with IOD compared to CD,19 especially in the psychological and handicap domains.17 And one study showed improvement in all domains except physical pain.17
Patients who were previously satisfied with their maxillary CD, did not report an increase of overall satisfaction, denture stability or better comfort despite implant treatment.8,17,21 However, patients treated with a maxillary IOD without palatal coverage reported higher satisfaction, better speech, and more effective hygiene measures compared to patients treated with a FID.8,21 The latter does not necessarily lead to higher patients’ satisfaction, although some studies indicate improved OHRQoL, compared to an IOD.8 For aesthetic reasons, a maxillary IOD can be preferred over a FID especially when more lip support is needed.21 Compared with a CD, both the mandibular and maxillary IOD reduce pain, enhance denture stability, comfort, and function.8
An important part of people’s quality of life is determined by the ability to communicate with others.22 One major way of communication is through speech. Regarding satisfaction with speech, 33% of CD wearers and 53% of patients treated with a FID state having problems related to the dental treatment.23 Treatment with mini-dental implants, placed in compromised bone in order to stabilize an IOD in the maxilla, improved satisfaction with speech18 as well as OHRQoL when converting the CD to an IOD in all 7 domains of the OHIP-14.19