Initial Speech Problems in Patients Treated with Multiple Zygomatic Implants

Purpose: The aim of this study was to investigate the speech ability of patients treated with multiple zygomatic implants. This technique can be used in patients with severe atrophy of the maxilla when there is insufficient residual bone in the anterior region for placement of conventional implants. Materials and Methods: Between 2004 and 2008, audio recordings were performed in patients treated with fixed dental prostheses (FDP) supported by multiple zygomatic implants. Patients with extensive resorption of the basal bone of the maxilla (Cawood and Howell Class VI) were included in the study. No bone grafts were used. Audio recordings were conducted before treatment (pretreatment), within 1 week after the FDP was inserted (1 week posttreatment), and then again after 4 months (4 months posttreatment). Perceptual evaluations of the recordings were performed by a panel of speech and language pathologists (n = 3), and the patients' subjective views of speech quality were investigated on the three different occasions. Results: Seven consecutive patients were treated with a total of 28 zygomatic implants and five conventional implants. All patients received a FDP. According to the evaluations by professionals, five of the seven patients, all of whom wore a removable conventional denture prior to treatment, had normal speech before treatment. One patient could not be evaluated by the professionals because of medical impairment. In five of the six remaining patients, a mild deterioration in articulation was registered at 1 week posttreatment, and these problems remained after 4 months. Patients' subjective views reflected a dramatic improvement in speech at 1 week posttreatment for the two patients presenting with the highest degree of maxillary bone resorption. The three patients who reported completely normal speech before treatment all experienced a drop in their ability at 1 week posttreatment. Four patients displayed a similar pattern after treatment according to the professionals' opinions and the patients' subjective reports. Conclusion: A mild deterioration in speech can be anticipated in patients subjected to treatment with a FDP supported by multiple zygomatic implants. Keywords: dental implants, maxilla, speech, zygoma