Five‐year clinical trial using three attachment systems for implant overdentures

<jats:title>Abstract</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>The objective is to compare, in a prospective randomized clinical trial, three types of attachment systems for mandibular implant overdenture, focusing on costs, maintenance requirements and complications from baseline to the end of 5‐year follow‐up period.</jats:p></jats:sec><jats:sec><jats:title>Materials and Methods</jats:title><jats:p>Sixty‐nine fully mandibular and fully/partially maxillary edentulous patients received two screw‐type Straumann implants, in the mandibular canine region. New overdentures with three types of attachment systems were inserted according to an early‐loading protocol: Group B (balls, divided into Subgroup B.1 – retentive anchor with gold matrix and Subgroup B.2 – retentive anchor with titanium matrix) (<jats:italic>n</jats:italic> = 23), Group M (magnets) (<jats:italic>n</jats:italic> = 23) and Group L (locator) (<jats:italic>n</jats:italic> = 23).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The highest maintenance event number (195) was observed in Group B vs. 31 in Group L and 15 in Group M. Significantly more complications were recorded in Subgroup B.1 than in Subgroup B.2, Group M and Group L (<jats:italic>P </jats:italic><<jats:italic> </jats:italic>0.05). Group M registered the highest prosthetic success (82.6%) in the 5 years, followed by Group L (78.2%). Subgroup B.1 had the lowest success rate (50%). The magnet group recorded statistically significant higher costs, comparing with the other two groups (<jats:italic>P </jats:italic><<jats:italic> </jats:italic>0.05).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The three attachment systems functioned well after 5 years. The magnets had a low maintenance requirement and high success rate, despite the relatively increased initial costs. Retentive anchor with titanium matrix and locator may be a better choice from a financial point of view, taking into consideration the initial low cost of the components and also the reduced number of complications.</jats:p></jats:sec>