Statement of problem: Overdentures can improve the quality of life of elderly patients compared with conventional complete dentures. Different attachment systems can be used to retain these prostheses, but which system results in better function, mechanical performance, and patient comfort is unclear.
Purpose: The purpose of this systematic review was to evaluate randomized clinical trials to compare overdentures supported by either bar and clip or ball and O-ring attachments for retention, masticatory efficiency, bone loss, and patient satisfaction.
Material and methods: A literature search was conducted in the PubMed and Web of Science databases. From 163 studies, 16 randomized clinical trials were included in this systematic review based on the inclusion and exclusion criteria. The risk of bias was evaluated according to the RevMan software Risk of Bias Table (RoB Table), and only the studies with a low or intermediate risk of bias were included in the review.
Results: From the limited number of studies, the attachment type did not affect the masticatory quality of the patients, bone loss marginal to the implants, or the degree of patient satisfaction. However, overdentures with the bar and clip attachment tended to have higher initial retention than the ball and O-ring system.
Conclusions: Both the bar and clip and ball and O-ring attachment systems presented similar clinical performance regarding mechanical and functional properties and patient satisfaction.
Copyright © 2019 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
A Clinical Trial of Patient Satisfaction and Prosthodontic Needs With Ball and Bar Attachments for Implant-Retained Complete Overdentures: Three-Year ResultsMI MacEntee et al. J Prosthet Dent 93 (1), 28-37. PMID 15623995. - Clinical TrialSubjects were very satisfied with the new dentures, although the ball-spring attachment tested in this trial required substantially more repairs.
Bar Versus Ball Attachments for Implant-Supported Overdentures in Complete Edentulism: A Systematic ReviewM Anas El-Wegoud et al. Clin Implant Dent Relat Res 20 (2), 243-250. PMID 29071777. - ReviewThere is insufficient evidence to support bar or ball attachment to be used with implant-supported overdentures in completely edentulous patients to improve patient satis …
Attachment Systems for Mandibular Implant Overdentures: A Systematic ReviewHY Kim et al. J Adv Prosthodont 4 (4), 197-203. PMID 23236571.The implant survival rate of mandibular overdentures seemed to be high regardless attachment systems. The prosthetic maintenance and complications may be influenced by at …
Mandibular Overdentures Retained by Two Implants: 10-year Results From a Crossover Clinical Trial Comparing Ball-Socket and Bar-Clip AttachmentsM Cune et al. Int J Prosthodont 23 (4), 310-7. PMID 20617218. - Randomized Controlled TrialPatients' appreciation of their implant-retained denture was and remained high over time. Clinical parameters revealed healthy mucosal conditions and stable marginal bone …
A Systematic Review of Marginal Bone Loss Around Implants Retaining or Supporting OverdenturesMC Cehreli et al. Int J Oral Maxillofac Implants 25 (2), 266-77. PMID 20369084. - ReviewBased upon a systematic review and meta-analysis of the literature that identified a total of 4,200 implants from 13 manufacturers, there was no difference in marginal bo …