Page 86 - Impact of implant retained overdenture treatment and speech, oromyofunction, social participation and quality of life.

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Chapter 3
(especially the /s/ sound), is not significantly lower when converting to the IOD or after 3 years follow-up. This was also seen in other studies.18,28 It is possible that patients already had speech disorders in the past which are not related to their denture that are ‘normal’ for the individual patient. Moreover it is possible that patients rate not only the sound but also the comfort of their speech. This is a feature a speech language pathologist cannot assess. Until now there is no study comparing satisfaction to speech from pre-treatment to 3 years follow up in IOD. The study of Lundqvist et al (1992) reported results of 21 patients, treated with a FID. 94% of these individuals considered themselves free of phonetic problems after 3 years follow-up. In this case, still a small amount of subjects were rated as having a ‘slightly distorted /s/ quality’.29 This is in agreement with our findings.
Figure 3 shows the averages on the seven domains of the OHIP-14. It is very clear that the difference between the impact of the denture, pre-treatment and the impact of the denture after connection and at follow-up is significantly better for all domains. There is no further improvement after connection of the IOD to the implants. These results are confirmed by the results of Van Doorne et al. (2020) on Mini Dental Implants (MDI) in the maxilla.19 In the review of Sharka et al. (2019), some studies reported increased OHRQOL when treated with IODs in all domains except physical pain. Others showed improvement, especially in the handicap and psychological domains.17
The major strength of this study is the prospective design and the use of two speech language pathologists for the evaluation of speech. The combination of articulation assessments and patients’ satisfaction with their overall oral health and speech, and OHRQoL makes it possible to take into account both the consensus evaluation by the speech language pathologists and subjective results reported by the patients. The negative side effect of a longitudinal design is the risk of drop-out, as is also the case in this study. Another difficulty in our study is the fact that patients already have complaints about their oral condition before they participate to the study. Ideally, a speech assessment should be performed with the original dental state so the articulation disorders that are already present, can be listed. In this way, articulation disorders related to the treatment can be detected independently from already existing distorted sounds. This study should be reproduced with (if possible) bigger sample