Available online 17 November 2023

Author links open overlay panel, , , , ABSTRACTPurpose

The purpose of this clinical study was to assess speech articulation in edentulous individuals before and after the provision of IFPs by combining the results of subjective evaluations and objective acoustic analysis parameters.

Material and methods

The study included thirty-four individuals who had an edentulous maxilla and had been provided with an IFP for over 6 months, along with 6 dentate controls. Acoustic analysis was conducted, and mean opinion scores (MOS) were rated from recordings. The participants were interviewed about perceived speech changes. Changes in the parameters were evaluated using the paired t test or Wilcoxon signed-rank test (α=.05). A comparison between dentate controls and edentulous individuals (with or without prostheses) was made using an independent t test or Mann-Whitney U test (α=.025).

Results

Following restoration, the center of gravity (CoG) changes occurred in 11 of 12 consonants in edentulous individuals (P<.05). Prosthesis use allowed the CoG of all affricates and fricatives to appear larger and closer to control values. Before restoration, the CoG of 9 of 12 consonants in edentulous individuals differed from controls (P<.01); after restoration, this reduced to 3 out of 12 (P<.01). MOS improved in 10 of 12 consonants (P<.01), nearing a score of 4. Despite restoration, the CoG of alveolo-palatals [tɕh], [tɕ], and [ɕ] remained different from controls (P<.01). Most participants were satisfied with the improvement, with few reporting discomfort with alveolars [s] and [tsh].

Conclusions

IFPs can enhance speech in edentulous individuals, yet articulation distortions of alveolar and alveolo-palatal consonants persist. The improper palatal shape of IFPs or an abrupt joint between the IFP and atrophic natural bone may contribute to these distortions.

Section snippetsMATERIAL AND METHODS

The study had been approved by the Medical Ethics Committee of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine (approval number: SH9H-2023-T169–1). All participants provided written informed consent before enrollment.

A total of 40 participants, including 34 individuals with an edentulous maxilla and a control group of 6 individuals with a natural dentition, were enrolled. The individuals with an edentulous maxilla were recruited from the Department of the

RESULTS

A total of 34 participants with IFPs (23 men and 11 women, aged 47.88 ±15.58 years, range 19 to 71 years) and 6 dentate individuals (3 women and 3 men, aged 36.83 ±9.08 years, range 27 to 53 years) were included. The demographics of the participants and rehabilitation information are presented in Table 1. The comparable age and sex distribution in both groups were verified by using the Mann–Whitney U and Fisher tests respectively (P>.05). A total of 74 recorded samples were collected: 68 from

DISCUSSION

The results of the present study showed that the acoustic parameters and MOSs of the affricates and fricatives changed significantly (P<.05) and a significant improvement in overall speech was observed in the IFP group. Therefore, the null hypothesis that no significant difference would be found in the acoustic characteristics before and after the restoration was rejected. In order to overcome the confounding factors and to ensure that the changes in acoustic parameters were solely because of

CONCLUSIONS

Based on the findings of this clinical study, the following conclusions were drawn:

1.

IFPs can enhance speech in individuals with an edentulous maxilla. However, the persistence of articulation disorders related to alveolar and alveolo-palatal consonants indicated that potential inadequacies exist in the restoration process of the palatal aspect of the prosthesis.

2.

These findings highlight the need for more focused prosthetic design, particularly in relation to the palatal side involved in the

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