Objective: This study aimed to evaluate and compare the effect of locator attachment and ball and socket (BS) attachment on the peri-implant and periabutment supporting structures on clinical pocket depth and gingival index in cases of limited interarch spaces in mandibular Kennedy class I implant-supported removable partial overdentures. Materials and methods: A comparative clinical trial was conducted among twenty partially edentulous patients aged 30–60 years. The study participants were randomly divided into two study groups based on the attachment system used: group I – locator attachment, and group II – BS attachment. Two implants were positioned in the 1st or 2nd molar area following the two-stage surgical protocol. Evaluation of the peri-implant and periabutment supporting structures was done at the time of overdenture insertion and after 6, 12, and 18 months by measuring the pocket depth and gingival index. Inter- and intragroup comparisons were done using independent-samples t test and paired-sample t test respectively. p < 0.05 was considered statistically significant. Results: It was observed that there was a statistically significant increase in the pocket depth around the implant as well as the abutment in both groups at 6, 12, and 18 months when compared to baseline. Intergroup comparison for pocket depth and gingival index revealed nonsignificant results. However, the values were higher in the BS group. Conclusion: The locator attachment group had lower, though statistically not significant, pocket depth and gingival index scores around both the dental implant and the natural abutment as compared with the BS attachment. Clinical significance: Gingival health surrounding dental implant attachments is very crucial for the long-term success of dental implant, this could help the clinician to select the proper design for implant attachment underneath the over denture prosthesis.
Mustafa AZ. Duplicating the implant O-ring abutment retainer for using on tooth copy in mandibular implant-tooth partial overdenture: radiographic Evaluations. Eur J Dent Med 2012;4(3):45–55. DOI: 10.3923/ejdm.2012.45.55.
Holmes JB. Influence of impression procedures and occlusal loading on partial denture movment. J Prosthet Dent 2001;86(4):335–341. DOI: 10.1067/mpr.2001.119826.
George WH. Load distribution in extension saddle partial denture. J Prosthet Dent 2001;85(4):324–329. DOI: 10.1067/mpr.2001.115609.
Shue L, Miron RJ, Yufeng Z. Review of implant support for the distal extension removable partial dentures. JSM Dent Surg 2016;1(1):1007.
Romeo E, Chiapasco M, Ghisolfi M, et al. Long-term clinical effectiveness of oral implants in the treatment of partial edentulism: seven-year life table analysis of a prospective study with ITI® dental implants system used for single-tooth restorations. Clin Oral Impl Res 2002;13(2):133–143. DOI: 10.1034/j.1600-0501.2002.130203.x.
Ohkubo C, Kurihara D, Shimpo H, et al. Effect of implant support on distal extension removable partial dentures: in vitro assessment. J Oral Rehabil 2007;34(1):52–56. DOI: 10.1111/j.1365-2842.2006.01641.x.
Jha DUK, Singhal MK, Nair C, et al. An evaluation of attachments: implant-supported overdentures. J Dent Sci Oral Rehab 2016;7(4): 174–177.
Ahmed YA. Attachments used with implant supported over denture. Adv Dent Oral Health 2016;1(2):555560. DOI: 10.19080/ADOH.2016.01.555560.
Trakas T, Michalakis K, Kang K, et al. Attachment systems for implant retained overdentures: a literature review. Implant Dent 2006;15(1):24–34. DOI: 10.1097/01.id.0000202419.21665.36.
Agrawat P, Chandan K, Mistry G, et al. Implant supported overdenture attachments. Int J Curr Res 2017;9(11):60607–60610.
van Kampen F, Cune M, van der Bilt A, et al. Retention and postinsertion maintenance of bar-clip, ball and magnet attachments in mandibular implant overdenture treatment: an in vivo comparison after 3 months of function. Clin Oral Implants Res 2003;14(6):720–726. DOI: 10.1046/j.0905-7161.2003.00961.x.
Tokuhisa M, Matsushita Y, Koyano K. In vitro study of a mandibular implant overdenture retained with ball, magnet, or bar attachments: comparison of load transfer and denture stability. Int J Prosthodont 2003;16(2):128–134.
Ciancio SG. Current status of indices of gingivitis. J Clin Periodontol 1986;13(5):375–378. DOI: 10.1111/j.1600-051X.1986.tb01476.x.
Mahrous AI, Aldawash HA, Soliman TA, et al. Implant supported distal extension over denture retained by two types of attachments. A comparative radiographic study by cone beam computed tomography. J Int Oral Health 2015;7(5):5–10.
Marianna P, Yoav G, Israel MF. A prosthetic solution to restoring the edentulous mandible with limited inter-arch space using an implant-tissue-supported overdenture, A clinical report. J Prosthet Dent 2005;93(2):116–120. DOI: 10.1016/j.prosdent.2004.09.024.
Jacobs R, Schotte A, van Steenberghe D, et al. Posterior jaw bone resorption in osseointegrated implant-supported overdentures. Clin Oral Implants Res 1992;3(2):63–70. DOI: 10.1034/j.1600-0501.1992.030203.x.
Schneider AL. Restoring implants with an overdenture using the locator implant attachment from Zest Anchors, Inc. Dent Prod Rep Tech Guide 2000.
Brånemark PI, Hansson BO, Adell R, et al. Osseointegrated implants in the treatment of the edentulous jaw. experience from a 10-year period. Scand J Plast Reconstr Surg Suppl 1977;16:1–132.
Assad AS, Hassan SA, Shawky YM, et al. Clinical and radiographic Evaluation of implant-retained mandibular overdentures with immediate loading. Implant Dent 2007;16(2):212–223. DOI: 10.1097/ID.0b013e318065a95f.
Turkyilmaz I, Tumer C. Early versus late loading of unsplinted TiUnite surface implants supporting mandibular overdentures: a 2-year report from a prospective study. J Oral Rehabil 2007;34(10):773–780. DOI: 10.1111/j.1365-2842.2006.01683.x.
Turkyilmaz I, Tozum TF, Tumer C, et al. A 2-year clinical report of patients treated with two loading protocols for mandibular overdentures: early versus conventional loading. J Periodontal 2006;77(12):1998–2004. DOI: 10.1902/jop.2006.060115.
De Smet E, Duyck J, Vander Sloten J, et al. Timing of loading-immediate, early or delayed-in the outcome of implants in the edentulous mandible: a prospective clinical trial. Int J Oral Maxillofac Imp 2007;22(4):580–594.
Meijer HJ, Raghoebar GM, Vant Hof MA, et al. A controlled clinical trial of implant-retained mandibular overdentures: 10 years results of clinical aspects and aftercare of IMZ implants and Branemark implants. Clin Oral Implants Res 2004;15(4):421–427. DOI: 10.1111/j.1600-0501.2004.01024.x.
Naert I, Alsaadi G, van Steenberghe D, et al. A 10-year randomized clinical trial on the influence of splinted and unsplinted oral implants retaining mandibular overdentures: peri-implant outcome. Int J Oral Maxillofac Implants 2004;19(5):695–702.
Visser A, Meijer HJ, Raghoebar GM, et al. Implant-retained mandibular overdentures versus conventional dentures: 10 years of care and aftercare. Int J Prosthodont 2006;19(3):271–278.
Habel KS, Galindo D, Gajjar RC. Implant position record and implant position cast: minimizing errors, procedures and patient visits in the fabrication of the milled-bar prosthesis. J Prosthet Dent 2000;83(1):107–116. DOI: 10.1016/S0022-3913(00)70095-3.
Budtz-Jørgensen E. Prosthodontics for the elderly: diagnosis and treatment. Batavia, Illinois: Quintessence Publishing; 1999.
Alamanos C, Stockle M, Rosentritt M, et al. Patient satisfaction with locator-retained overdentures. J Clin Mol Med 2018;1:1–2. DOI: 10.15761/JCMM.1000115.
Fernandez-Estevan L, Selva-Otaolaurruchi EJ, Montero J, et al. Oral health-related quality of life of implant-supported overdentures versus conventional complete prostheses: retrospective study of a cohort of edentulous patients. Med Oral Patol Oral Cir Bucal 2015;20:e450–e458. DOI: 10.4317/medoral. 20498.
Khalid T, Yunus N, Ibrahim N, et al. Patient-reported outcome and its association with attachment type and bone volume in mandibular implant overdenture. Clin Oral Implants Res 2017;28(5):535–542. DOI: 10.1111/clr.12831.
Engelhardt F, Zeman F, Behr M, et al. Prosthetic complications and maintenance requirements in locator-attached implant-supported overdentures: a retrospective study. Eur J Prosthodont Restor Dent 2016;24(1):31–35.
Schneider AL. The use of a self-aligning, low-maintenance overdenture attachment. Dent Today 2000;19(4):24–26.
Chikunov I, Doan P, Vahidi F. Implant-retained partial overdenture with resilient attachments. J Prosthodont 2008;17(2):141–148. DOI: 10.1111/j.1532-849X.2007.00261.x.