INTRODUCTION:The incorporation of attachments in overdentures into everyday dental practice will open up another dimension in dental treatment planning and patient satisfaction. Teeth that might be considered for extraction may be considered as long or short term alternatives to implant or total edentulousness. Some teeth are maintained to support and/or retain the prosthesis and therefore, maximizing prosthesis stability, besides preserving proprioception of the periodontal ligament and reducing bone loss. Tooth-supported overdentures can be retained with attachments and can improve both retention and stability while simultaneously reducing alveolar bone resorption. They may also be more costeffective and maintain more dental proprioception than implant-supported overdentures. OBJECTIVES: To compare clinically and radiographically between flex pivot (precision attachment with flexible male sphere) and castable pivot (semiprecision attachment) used for root-supported overdenture. MATERIALS AND METHOD:This randomized parallel controlled clinical study was conducted on twelve patients having bilateral mandibular single rooted teeth; canines or first premolars. Those were divided into two groups of six subjects. Group A (study group) each of six patients received flex pivots (precision attachment with flexible male sphere) bilaterally as test group. Group B (control group) six patients received castable pivots (semiprecision attachment) bilaterally as control group. RESULTS: When the data of changes in the clinical and radiographic parameters of periodontal status over a 6 months period were compared at immediate post-treatment, 1, 3, and 6 months intervals relative to type of attachment, the findings revealed there were no significant differences among precision attachment group in most of the mean values, while the opposite was shown in semiprecision attachment. CONCLUSIONS: Precision attachment with flex pivot was associated with more superior clinical periodontal parameters than precision attachment, and it is more biocompatible, hygienic, and maintaining healthy, stable periodontal soft tissue and crestal alveolar bone level.