Clinical and radiographic evaluation of bar, telescopic, and locator attachments for implant-stabilized overdentures in patients with mandibular atrophied ridges: A randomized controlled clinical trial

Purpose: The aim of this study was to evaluate the clinical and radiographic peri-implant tissues of bar, Locator, and resilient telescopic attachments for two-implant stabilized overdentures in subjects with mandibular atrophied ridges. Materials and Methods: Ninety edentulous individuals with mandibular ridge atrophy were randomly assigned into three equal groups and received two implants in the canine areas. Mandibular overdentures were constructed and attached to implants with Dolder bar attachments (BOD), resilient telescopes (TOD), and Locators (LOD). Plaque scores, gingival scores, pocket depths, implant stability, width of keratinized mucosa, vertical bone loss, and horizontal bone loss were evaluated at the time of prosthesis delivery and 6 months and 12 months after delivery. Results: With the exception of pocket depth and implant stability, all parameters showed a significant increase from prosthesis delivery to 6 months. BOD recorded the highest plaque scores, gingival scores, and pocket depths followed by LOD, and TOD recorded the lowest values. No significant difference in implant stability and keratinized mucosa was observed between groups. TOD and BOD recorded the highest vertical and horizontal bone losses, respectively. LOD recorded the lowest vertical and horizontal bone losses. There was no difference in implant survival rate between groups. Conclusion: Bar, resilient telescopic, and Locator attachments can be used successfully for two-implant stabilized overdentures in subjects with mandibular atrophied ridges after a 1-year follow-up period. Telescopic attachments were associated with improved clinical peri-implant soft tissues compared with other attachments. However, Locator attachments may be advantageous in terms of peri-implant bone preservation.