The underestimated complication associated with full-arch implant prostheses
In modern implant dentistry, full-arch fixed prostheses (like All-on-X) have gained a lot of popularity. There is a wealth of literature discussing problems with this kind of prosthesis, including fractures, hygienic problems, and cosmetic problems. Speech or phonetic issue is a serious complication that can be devastating but is frequently disregarded. For example, Collaert et al. reported that 84% of patients with full-arch fixed implant prostheses showed one or more pronunciation errors after 6 years, and Van Lierde et al. reported that more than 87% had at least one consonant phonetic deficit. These and other clinical studies have revealed a high prevalence of speech issues with fixed implant prostheses.
Unfortunately, a lot of clinicians do not emphasize how a prosthesis’ design and type may affect the speech process. The position and musculature of the tongue control how well one can pronounce various phonetic sounds. It is crucial that the clinician is aware of how the prosthesis interacts with the tongue, teeth, and lips when taking maxillomandibular records for patients. Many patients with fixed full-arch implants initially struggle to pronounce consonants. The final implant prosthesis can alter the following examples of specific consonant sounds:
- “F” and “V” (labiodental sounds).
- “S,” “Z,” “SH,” and “ZH” (sibilant sounds).
- “TH” and “L” (linguo-dental sounds).
- “B,” “M,” and “P” (bilabial sounds)
- “D,” “N,” and “T” (tongue to anterior lingual teeth sounds).
Chaturvedi S, Gupta N, Tandon A. Speech considerations. J Dental Med Sciences.2015;14(17):34-36.
Collaert B, Van Dessel J, Konings M, et al. On speech problems with fixed restorations on implants in the edentulous maxilla: introduction of a novel management concept. Clin Implant Dent Relat Res. 2015;17 Suppl 2:e745–50. doi:10.1111/cid.12309
Van Lierde K, Browaeys H, Corthals P, Muss- che P, Van Kerkhoven E, De Bruyn H. Comparison of speech intelligibility, articulation and oromyofunctional behaviour in subjects with single-tooth implants, fixed implant prosthetics or conventional removable prostheses. J Oral Rehabil. 2012;39(4):285–93. doi:10.1111/j.1365-2842.2011.02282.x