Hard and soft-tissue evaluation of bar-clip, ball-socket, and kerator attachments in mandibular implant overdenture treatment: An in vivo study

Abstract

Aim: The aim of this in vivo study was to evaluate and compare the soft and hard tissue changes in implant supported mandibular overdenture with three different attachment system. Settings and Design: In vivo – observation study. Materials and Methods: After evaluation of prosthetic space, fifteen edentulous subjects received two implants in the inter-foramina region of the mandible and were divided into 3 groups with 5 subjects each, delayed loading protocol was followed in all the patients. The crestal bone loss, modified sulcular bleeding index, plaque index values were evaluate with the attachments at baseline and after 6 months was measured in a standardised way. Statistical Analysis Used: Oneway ANOVA test and post hoc Bonferroni multiple test. Results: At the end of six months modified sulcular bleeding index and plaque index values was higher in Group 2 (bar and clip attachment) as compared to Group 1 (ball and socket attachment) and Group 3 (Kerator attachment) and crestal bone loss was equal in groups 1, 2 and 3. Analysis of variance with repeated measures showed significant differences in modified sulcular bleeding index and plaque index among the three attachment types. Conclusion: (1) Group 2 (bar-and-clip attachment) exhibited higher Modified Sulcular Bleeding Index and Plaque Index values than Group 1 (ball-and-socket attachment) and Group 3 (kerator attachment). (2) Crestal bone loss was equal in Group 1 (ball-and-socket attachment), Group 2 (bar-and-clip attachment), and Group 3 (kerator attachment).

Crestal Bone Changes and Patient Satisfaction with Single Implant‐Retained Mandibular Overdentures with Dalla Bona and Locator Attachments with Immediate Loading Protocols. A Randomized Controlled Clinical Study

“…21,22 Researchers have done studies comparing different attachment systems used to retain two IODs with delayed loading protocols. [23][24][25][26] Dalla Bona, ball and socket, and Locators have routinely used attachments and provide good retention and stability and are easy to use. [27][28][29][30][31][32] There is a lack of literature comparing the outcomes of immediate loaded Dalla Bona and Locator attachments in single implant-retained mandibular overdentures (SIMO).…”

“…There are different attachment systems for mandibular implant‐retained overdentures to minimize movement of the denture without producing stress on the implants 21,22 . Researchers have done studies comparing different attachment systems used to retain two IODs with delayed loading protocols 23‐26 . Dalla Bona, ball and socket, and Locators have routinely used attachments and provide good retention and stability and are easy to use 27‐32 .…”

Radiographic Evaluation of Bar/Locator versus Bar/ball for Implant Assisted Complete Mandibular Overdenture (A 5-Year Retrospective Study).

“…Proximal crestal bone loss was measured with the long cone paralleling technique, which has been used in much previous research with minor modifications. To count any magnification that might have been produced and made measurement easier by radiographic grid (18) .…”

A systematic review and meta-analysis of the attachments used in implant-supported overdentures

“…[ 43 ] Recently, there are various emerging attachment systems like Kerators provide higher degree retention and patient satisfaction[ 44 ] but with more mucosal changes. [ 45 ] The rate of retention loss in attachments was higher in attachments with plastic parts within their components, rather than those totally made up of noble metals. [ 46 ] Further Randomised Controlled trials are required for evaluation of newer attachment systems in terms of retention loss and mucosal changes.…”