Bar versus ball attachments for maxillary four-implant retained overdentures: A randomized controlled trial

Area of Science:

• Dental Implantology
• Prosthodontics
• Periodontology

Background:

• Conventional complete dentures often lead to patient dissatisfaction.
• Maxillary implant-retained overdentures offer an improved treatment option.
• Attachment systems, such as splinted (bar) and non-splinted (ball), influence outcomes.

Purpose of the Study:

• To compare clinical treatment outcomes of maxillary four-implant retained overdentures using splinted (bar) versus non-splinted (ball) attachments.
• To evaluate implant success, peri-implant tissue health, prosthodontic maintenance, and patient satisfaction.

Main Methods:

• A randomized controlled trial included 40 participants dissatisfied with conventional dentures.
• Definitive prostheses were delivered six months after implant placement.
• Outcomes assessed included implant success, peri-implant tissue condition, maintenance, complications, and patient satisfaction at baseline, prosthesis delivery, and 3 and 12 months post-delivery.

Main Results:

• Thirty-two participants completed the 1-year follow-up.
• Mean marginal bone loss was 0.34 ± 0.88 mm, with no significant difference between groups.
• The bar group exhibited significantly higher plaque index, gingival index, and bleeding on probing (p<.001).
• Implant success rate was significantly lower in the bar group (p=.028).
• Frequent maintenance issues in the bar group involved retention loss requiring clip/O-ring replacement.
• Patient satisfaction was comparable, except for aesthetics at 3 months.

Conclusions:

• Maxillary four-implant retained overdentures provide predictable results at 1-year follow-up, irrespective of attachment type.
• The bar attachment group demonstrated increased vulnerability in maintaining peri-implant tissue health compared to the ball attachment group.