Page 95 - Impact of implant retained overdenture treatment and speech, oromyofunction, social participation and quality of life.

Speech, OMF and OHRQoL in OD on MDI in the maxilla
Introduction
Speech is a part of a larger system called communication. In this study we focused on the part of speech called articulation. Articulation involves the movement of the speech production mechanism, the so-called articulators (e.g., the jaw, lips, tongue and the soft palate). This mechanism molds the air stream, coming from the lungs, against the other structures in the mouth (alveolar ridge, hard palate and teeth) or narrows the airstream, resulting in high pitched sounds. Speech sounds are characterized by the way the speech structures are positioned.1 In the study of articulation disorders, different causes of deviant speech are known. There are two main categories in articulation problems. Firstly, functional problems caused by a wrong use of the articulatory muscles. Secondly, organic problems which appear due to changes of the structures responsible for articulation.1 Hence, it is obvious that modifications in the form and location of teeth, as is the case with tooth loss, denture wearing or tooth rehabilitations, may affect speech. Life expectancy is rising and provided that oral hygiene measures are applied properly, patients will keep their natural teeth longer and functional. However, large proportions of patients are edentulous and wear removable dentures leading to reduced functional comfort and less oral health related quality of life.2 Lack of stability and retention as well as decreased chewing ability is the most prevalent patient complaint.3 Moreover, long time removable denture wearing induces further bone resorption and decreases functionality of the denture. Dental implants are useful in the improvement of denture retention and the overdenture on two implants in the lower jaw has been suggested as the minimal standard of care.4 Long-term implant survival for dentures is in the order of 93% to 97%.5 For the majority of the edentulous patients, a 2-4 mandibular implant overdenture provides a satisfying treatment solution with 95% implant survival after 10 years.6 Treatment with conventional dental implants of at least 3.5mm diameter is the most common way to anchor a dental prosthesis.7 However, some patients present with an advanced resorption of their jawbone whereby regular dental implants cannot be placed due to limitations in bone morphology. In those cases often invasive reconstructive bone regenerative procedures are required with higher costs, more morbidity and higher barrier for treatment as compared to conventional implant placement.8,9 Furthermore, aging edentulous patients are often medically compromised and benefit more from minimally invasive
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