Faculty of Medicine and Health Sciences, Department of Oral Health Sciences, Section Periodontology and Oral Implantology, Ghent University, Ghent, Belgium.
Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands.
Clin Implant Dent Relat Res. 2021 Jun;23(3):388-399. doi: 10.1111/cid.12989. Epub 2021 Feb 22.
Modifications of facial and oral structures affect aesthetic appearance, orofacial functions, and have impact on quality of life.
This study determined alterations of articulation, oromyofunctional behavior, and Oral Health Related Quality of Life (OHRQoL) in patients replacing complete removable dentures by implant retained overdentures in the mandible.
Twenty-one fully edentulous patients received mandibular overdenture retained on a bar connecting two titanium dental implants. Patients were evaluated after receiving a new set of fully removable dentures (stage 1), after surgery during provisionalization on healing abutments (stage 2), and after final connection to the bar (stage 3). Assessments were taken by speech therapists and included evaluation of: articulation (picture naming and reading); oromyofunctional behavior; OHRQoL (OHIP-14 questionnaire), and overall satisfaction and speech (VAS). To measure changes over time, Wilcoxon matched-pairs signed-rank-test and McNemar test was used.
There was no significant impact of the treatment on speech nor on the results of oromyofunction. In stage 1, patients had different kinds of articulation errors (mean:1.21) which evolved to 0.71 and 0.67. In stage 3, especially problems with the /s/ sound are seen in 37% (7/19) of the participants. Results of OHRQoL and satisfaction reveal that the average of satisfaction with oral health evolved from 67% to 63% and finally 78%. OHIP-14 total score was 17.4/56 in stage 1, remained unchanged in stage 2 and evolved in stage 3 to 9.8/56 (P: .010). This indicates improvement. Satisfaction with speech evolved significantly from 68% pretreatment to 82% in stage 3 (P: .013).
Despite existing articulation and oromyofunctional disorders after treatment, people are very satisfied with their OHRQoL and their speech. Impact of mandibular denture wearing on OHRQoL declines once connected. It's important to inform patients that speech and oromyofunctional disorders may occur during treatment where especially the /s/ sound is vulnerable.
面部和口腔结构的改变会影响美观、口颌功能，并影响生活质量。
本研究旨在确定下颌完全可摘义齿修复患者改用种植体支持的覆盖义齿后，在发音、口颌运动功能和口腔健康相关生活质量（OHRQoL）方面的改变。
21 名无牙颌患者下颌均采用杆连接两个钛种植体的覆盖义齿修复。患者在接受新的全口可摘义齿（第 1 阶段）、愈合基台临时修复（第 2 阶段）和最终与杆连接（第 3 阶段）后接受评估。由言语治疗师进行评估，包括发音（图片命名和阅读）、口颌运动功能、OHRQoL（OHIP-14 问卷）、总体满意度和语音（VAS）。为了测量随时间的变化，使用 Wilcoxon 配对符号秩检验和 McNemar 检验。
治疗对语音和口颌运动功能无显著影响。在第 1 阶段，患者存在不同类型的发音错误（平均：1.21），逐渐减少至 0.71 和 0.67。在第 3 阶段，37%（7/19）的参与者存在明显的/s/音问题。OHRQoL 和满意度的结果表明，对口腔健康的满意度平均从 67%提高到 63%，最后提高到 78%。第 1 阶段的 OHIP-14 总分为 17.4/56，第 2 阶段无变化，第 3 阶段发展为 9.8/56（P：.010），提示改善。语音满意度从治疗前的 68%显著提高到第 3 阶段的 82%（P：.013）。
尽管治疗后存在发音和口颌运动功能障碍，但患者对 OHRQoL 和语音非常满意。下颌义齿佩戴对 OHRQoL 的影响在连接后会降低。告知患者在治疗过程中可能会出现语音和口颌运动功能障碍，特别是/s/音容易受到影响非常重要。
