Comparative Evaluation of Various Implant Overdenture Attachment Systems in Terms of Survival Rate, Tissue Response,...

Edentulism is a common issue among the elderly, and implant-supported overdentures have been shown to enhance retention, stability, and overall patient satisfaction. The selection of an appropriate attachment system plays a crucial role, as different attachments can impact peri-implant tissue conditions, survival rates, and clinical outcomes. This systematic review and meta-analysis aimed to compare various attachment systems for mandibular implant overdentures based on tissue response, survival rate, and patient satisfaction. A comprehensive electronic and manual literature search was conducted using PubMed, Cochrane Central, and ScienceDirect databases. The review included randomized controlled trials and crossover clinical trials published between 2010 and 2020, with a minimum follow-up period of one year. The risk of bias was evaluated using the Cochrane Collaboration's tool, and statistical analysis was performed using RevMan 5.4 (The Cochrane Collaboration, London, UK). A total of 14 studies met the inclusion criteria, all exhibiting a low risk of bias. Overall, bar attachments demonstrated superior retention, while telescopic attachments were associated with the highest levels of patient satisfaction. Locator attachments proved advantageous for cases with limited interarch space and angulated implants. In contrast, magnetic attachments exhibited the least retention and were associated with more soft tissue changes. The analysis did not reveal a significant correlation between implant survival rates and the type of attachment used.