Page 85 - Impact of implant retained overdenture treatment and speech, oromyofunction, social participation and quality of life.

Speech and OHRQoL in OD treatment in the maxilla
with the tongue tip close to the upper or lower alveolar ridge. This is a well- known articulation disorder in dental rehabilitation.18,23,26–28,30,33 Because of the remaining articulation problems when converting to the IOD, we can conclude that removing the palatal coverage along with better retention and stability of the denture, does not solve all articulation disorders. According to Collaert and colleagues (2015), a reduction of the palatal volume in the (pre)molar region of a FID can result in improvement or even return to baseline level of speech.33 Besides the palatal thickness, the inclination of maxillary central incisors influences speech. The palatal or labial inclination of these incisors can result in direct changes of the production of the /s/ sound.34 As expected, no distortions of the (semi-) vowels were observed. This is parallel to previous studies.23,27,28,30 Vowels are produced without constriction in the oral cavity. For this reason, a denture has little impact on the production of vowels.
This study, secondly, focused on the possible influence of the dental situation on satisfaction and quality of life. Besides the professional evaluation of articulation of speech sounds by the speech language pathologists and the dental treatment by the dentist, it is important to take the subjective experience of patients into account. Patients reported low scores for overall satisfaction and OHRQoL pre-treatment. According to literature, chewing ability, denture comfort, stability and retention are the most reported patient complaints in CD wearers.8 In the present study, the overall satisfaction with oral health increased significantly when comparing the CD and the IOD. The reviews of Sharka (2019) and De Bruyn (2015) reported both increased patient satisfaction, as well as no improvement regarding satisfaction in patients satisfied with their maxillary denture.9,18 An explanation can be that patients signing up for this study are not satisfied or have difficulties adapting to their CD. The OHRQoL, measured by the OHIP-14, improved during all stages of treatment and after a three year follow-up period. This was also reported by other authors researching maxillary IODs.19,20
The satisfaction with articulation proficiency increased during all phases of treatment. Simultaneously a higher OHRQoL concerning speech, measured by the first question of the OHIP-14, was reported. A significant increase of satisfaction with speech was observed when comparing CD with three years follow-up. This is remarkable, because the number of speech disorders
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