Objective: The aim of this study was to compare the clinical and radiographic changes on peri-implant tissue health between bar , telescopic and locator attachments used to stabilize the mandibular two-implant retained overdentures in patients with atrophied mandibular ridges.
Materials and methods: In a randomized-controlled clinical trial, 18 edentulous patients aged 45 to 70 years were equally assigned to three groups. In each patient, two implants were inserted in the canine area of the mandible using a flapless surgical protocol.implants were early loaded after implant placement by reliened old denture, and then functional implant loading with final overdentures through implant attachments was performed 3 months after implant placement. (group I) bar, (group II) Telescopic and (group III) Locator attachment. Peri-implant tissues were evaluated clinically (with regard to plaque scores,gingival scores , probing depths , keratinized mucosa width and implant stability) and radiographically (with regard to peri-implant vertical and horizontal alveolar bone changes). Evaluations were performed at the time of overdenture insertion (T0),6 months (T6) and 12 months (T12) after overdenture insertion.
Results: After 12 months, the PI,GI and PD increased significantly in advance of time,and the BOD was the highest followed by LOD then TOD was the lowest group.KM and Implant stability decreased in advance of time but not significantly and no difference between groups. VBL and HBL increased significantly from T6 to T12 for all groups, TOD recorded the highest VBL, followed by BOD and LOD recorded the lowest VBL at T6 and T12, BOD recorded the highest HBL, followed by TOD and LOD recorded the lowest at T6 and T12.
Conclusion: Within the limitations of this study, and in terms of peri-implant tissue health. Bar, resilient telescopic and locator attachments can be used successfully to retain mandibular 2 implant overdentures in patients with atrophied mandibular ridges with good survival rate after one year follow up period.