Influence of prostheses over implants on speech and swallowing threshold of edentulous elderly people

Author(s)

Ingrid Andrade Meira

• Document type: Doctoral Thesis
• Press: Piracicaba, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Odontologia de Piracicaba
• Defense date: 2021-05-07

Examining board members

Renata Cunha Matheus Rodrigues Garcia; Giselle Rodrigues Ribeiro; Ana Carolina Pero Vizoto; Raissa Micaella Marcello Machado; Luciana Asprino

• Advisor: Renata Cunha Matheus Rodrigues Garcia

Abstract

Implant-supported complete dentures (ISDs) can be treatment alternatives to improve the retention and stability of removable complete dentures (CDs). It is known that CDs improve the chewing and the speech articulation distortion from CDs users. Therefore, it is necessary to summarize the literature to understand the contributions of ISDs use on speech articulation. Furthermore, little is known about the influence of single implant mandibular overdentures (SIMOs) on speech, mandibular movements, and swallowing threshold of edentulous elderly people. Therefore, this study aimed to: systematically review articulation disorders in users of CDs and ISDs with at least one edentulous dental jaw (chapter 1); to examine by a paired clinical study, speech articulation, mandibular movements during speech and swallowing threshold in elderly people rehabilitated with new CDs and SIMOs (chapter 2). In the systematic review, searches were performed in databases and PICO strategy was applied (Participants: subjects with at least one edentulous dental arch, Intervention: ISDs, Comparator: CDs and Outcome: articulation disorders). In the clinical study, 22 elderly people (66.7 ± 4.6 years) unsatisfactory CDs users, with normal or mild hearing loss (Lloyd & Kaplan, 1978), and with Class II and III mandibular ridges, according to the American College of Prosthodontists (1999), were selected. Speech articulation, mandibular movements during speech, and the swallowing threshold of elderly people were assessed with old CDs. Then, the elders received new conventional CDs, and after 2 months of use, the variables were again examined. Subsequently, an implant was installed in the mandible midline, and after the period of osseointegration, new mandibular CDs were converted into SIMOs. After 2 months of SIMOs using, the elders were evaluated. Cochran-Mantel-Haenszel test was used to compare articulation disorders among prosthetic treatments, and ANOVA and t test for mandibular movements and swallowing threshold. In the systematic review, it was found that distortions in the /s/ were more frequent in the first 6 months of fixed maxillary ISDs than with CDs. No difference was reported for articulation disorders between fixed ISDs and mandibular CDs users. However, the quality of the evidence for articulation disorders was very low. In the clinical study, no difference was observed in the speech articulation between new CDs and SIMOs (P> 0.05). A reduction in the frequency of anterior lisp was found for /s/ and /z/ after new CDs insertion when compared to old ones (P <0.05) use. X50 decreased (P <0.05) after new CDs and SIMOs. Therefore, it can be concluded that fixed maxillary ISDs in the first 6 months of use can contribute to a distortion of /s/ phoneme in patients who were already using CDs. However, this finding should be analyzed with caution. In the short-term, the main advantage of SIMOs use refers to better food trituration. New interdisciplinary studies evaluating the speech of users of dental prostheses are necessary (AU)

• FAPESP's process: 18/23013-4 - Impact of overdentures retained by a single mandibular implant on the swallowing threshold, quality of life and speech of edentulous elderly
• Grantee: Ingrid Andrade Meira
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)