Evaluation of Retention, Wear, and Maintenance of Attachment Systems for Single- or Two-Implant-Retained Mandibular Overdentures: A Systematic Review

Overview

Journal Materials (Basel)

Publisher MDPI

Date 2022 Mar 10

PMID 35269164

Authors

Raphael Wakam

Aurelie Benoit

Kwamivi Bernardin Mawussi

Caroline Gorin

Affiliations

Soon will be listed here.

Abstract

Attachment systems (AS) enhance retention and stability by anchoring the overdentures to implants. Since 2002, the McGill consensus statement recommends the 2-implant-retained overdentures as the standard choice for edentulous mandible (2-IRMO). Considering the large number of AS available, it remains difficult for a practitioner to make a reasoned choice. A systematic review was conducted in PubMed/Medline and carried out independently by three authors, on retention, wear, and maintenance of AS used clinically or in vitro specifically for 1- or 2-IRMO. The 45 selected studies include 14 clinical and 31 in vitro studies. The risk of bias was evaluated according to the revised Cochrane risk of bias tool for randomized trials (RoB 2). The initial retention force of the cylindrical system is higher than the ball system. The retention loss, related to the wear of the retention device, is responsible for the most common need of maintenance, requiring activation or replacement. Plastic retention devices wear out faster and more significantly than metal ones, implying a worse time behavior of cylindrical systems, but their maintenance rate is similar. Neither system appears categorically superior. Cylindrical systems provide higher initial retention than ball ones; this advantage reduces over time with wear without affecting their need for maintenance.

Citing Articles

Retention of Ti Si snap versus locator attachments with retention sil in two-implant retained mandibular overdentures: an in vitro study.

Mourad D, El-Mahrouky N, El-Dayem M, Shawky Y BMC Oral Health. 2025; 25(1):318.

PMID: 40022043 PMC: 11869697. DOI: 10.1186/s12903-025-05625-y.

Fixed Full-Arch Implant-Supported Restorations: Techniques Review and Proposal for Improvement.

Froimovici F, Butnarasu C, Montanari M, Sandulescu M Dent J (Basel). 2024; 12(12).

PMID: 39727465 PMC: 11674276. DOI: 10.3390/dj12120408.

Single versus two dental implants retained mandibular over dentures: comparison of function, patient satisfaction, oral health-related quality of life and success of treatment.

Jayasinghe R, Attygalla M, Fonseka M, Abeysundara S, Thilakumara I, Jayasinghe R BMC Res Notes. 2024; 17(1):374.

PMID: 39707530 PMC: 11662757. DOI: 10.1186/s13104-024-07040-y.

Finite Element Combined Design and Material Optimization Addressing the Wear in Removable Implant Prosthodontics.

Shayanfard P, Tan X, Karl M, Wendler F J Funct Biomater. 2024; 15(11).

PMID: 39590548 PMC: 11595149. DOI: 10.3390/jfb15110344.

Digital wear analysis and retention of poly-ether-ether-ketone retentive inserts versus conventional nylon inserts in locator retained mandibular overdentures: in-vitro study.

Fayed M, Elsherbini N, Mohsen B, Osman R Clin Oral Investig. 2024; 28(9):468.

PMID: 39105859 PMC: 11303480. DOI: 10.1007/s00784-024-05831-y.

References

Abi Nader S, de Souza R, Fortin D, De Koninck L, Fromentin O, Albuquerque Junior R . Effect of simulated masticatory loading on the retention of stud attachments for implant overdentures. J Oral Rehabil. 2010; 38(3):157-64. DOI: 10.1111/j.1365-2842.2010.02145.x. View

Stephens G, Vitale N, OSullivan E, McDonald A . The influence of interimplant divergence on the retention characteristics of locator attachments, a laboratory study. J Prosthodont. 2014; 23(6):467-75. DOI: 10.1111/jopr.12144. View

Salehi R, Shayegh S, Johnston W, Hakimaneh S . Effects of interimplant distance and cyclic dislodgement on retention of LOCATOR and ball attachments: An in vitro study. J Prosthet Dent. 2019; 122(6):550-556. DOI: 10.1016/j.prosdent.2018.12.023. View

ELsyad M, Abo Hatem O, Shawky A, Emera R . Effect of Different Degrees of Mesial Implant Inclination on the Retention and Stability of Two-Implant Mandibular Overdentures Retained with Stud Attachments: An In Vitro Study. Int J Oral Maxillofac Implants. 2017; 33(2):259–268. DOI: 10.11607/jomi.5791. View

Alsabeeha N, Atieh M, Swain M, Payne A . Attachment systems for mandibular single-implant overdentures: an in vitro retention force investigation on different designs. Int J Prosthodont. 2010; 23(2):160-6. View

Srinivasan M, Schimmel M, Kobayashi M, Badoud I, Ammann P, Herrmann F . Influence of different lubricants on the retentive force of LOCATOR(®) attachments - an in vitro pilot study. Clin Oral Implants Res. 2015; 27(7):771-5. DOI: 10.1111/clr.12680. View

Wolf K, Ludwig K, Hartfil H, Kern M . Analysis of retention and wear of ball attachments. Quintessence Int. 2009; 40(5):405-12. View

You W, Masri R, Romberg E, Driscoll C, You T . The effect of denture cleansing solutions on the retention of pink locator attachments after multiple pulls: an in vitro study. J Prosthodont. 2011; 20(6):464-9. DOI: 10.1111/j.1532-849X.2011.00722.x. View

Rabbani S, Juszczyk A, Clark R, Radford D . Investigation of retentive force reduction and wear of the locator attachment system with different implant angulations. Int J Oral Maxillofac Implants. 2015; 30(3):556-63. DOI: 10.11607/jomi.3687. View

10.

Alsabeeha N, Payne A, De Silva R, Thomson W . Mandibular single-implant overdentures: preliminary results of a randomised-control trial on early loading with different implant diameters and attachment systems. Clin Oral Implants Res. 2010; 22(3):330-7. DOI: 10.1111/j.1600-0501.2010.02004.x. View

11.

Fromentin O, Lassauzay C, Abi Nader S, Feine J, de Albuquerque Jr R . Clinical wear of overdenture ball attachments after 1, 3 and 8 years. Clin Oral Implants Res. 2011; 22(11):1270-4. DOI: 10.1111/j.1600-0501.2010.02102.x. View

12.

Petropoulos V, Mante F . Comparison of retention and strain energies of stud attachments for implant overdentures. J Prosthodont. 2011; 20(4):286-93. DOI: 10.1111/j.1532-849X.2011.00699.x. View

13.

Al-Ghafli S, Michalakis K, Hirayama H, Kang K . The in vitro effect of different implant angulations and cyclic dislodgement on the retentive properties of an overdenture attachment system. J Prosthet Dent. 2009; 102(3):140-7. DOI: 10.1016/S0022-3913(09)60134-7. View

14.

Nogueira T, Aguiar F, de Barcelos B, Leles C . A 2-year prospective study of single-implant mandibular overdentures: Patient-reported outcomes and prosthodontic events. Clin Oral Implants Res. 2018; 29(6):541-550. DOI: 10.1111/clr.13151. View

15.

Ortegon S, Thompson G, Agar J, Taylor T, Perdikis D . Retention forces of spherical attachments as a function of implant and matrix angulation in mandibular overdentures: an in vitro study. J Prosthet Dent. 2009; 101(4):231-8. DOI: 10.1016/S0022-3913(09)60045-7. View

16.

ELsyad M, Emera R, Ashmawy T . Effect of Distal Implant Inclination on Dislodging Forces of Different Locator Attachments Used for Mandibular Overdentures: An In Vitro Study. J Prosthodont. 2017; 28(2):e666-e674. DOI: 10.1111/jopr.12710. View

17.

Turk P, Geckili O, Turk Y, Gunay V, Bilgin T . In vitro comparison of the retentive properties of ball and locator attachments for implant overdentures. Int J Oral Maxillofac Implants. 2014; 29(5):1106-13. DOI: 10.11607/jomi.3621. View

18.

Cune M, Verhoeven J, Meijer G . A prospective evaluation of Frialoc implants with ball-abutments in the edentulous mandible: 1-year results. Clin Oral Implants Res. 2004; 15(2):167-73. DOI: 10.1111/j.1600-0501.2004.00981.x. View

19.

Kleis W, Kammerer P, Hartmann S, Al-Nawas B, Wagner W . A comparison of three different attachment systems for mandibular two-implant overdentures: one-year report. Clin Implant Dent Relat Res. 2009; 12(3):209-18. DOI: 10.1111/j.1708-8208.2009.00154.x. View

20.

Maniewicz S, Badoud I, Herrmann F, Chebib N, Ammann P, Schimmel M . In vitro retention force changes during cyclic dislodging of three novel attachment systems for implant overdentures with different implant angulations. Clin Oral Implants Res. 2019; 31(4):315-327. DOI: 10.1111/clr.13567. View