J Prosthodont. 2026 Mar 1. doi: 10.1111/jopr.70115. Online ahead of print.
ABSTRACT
PURPOSE: Mandibular two-implant overdentures represent the standard of care for edentulous patients; however, long-term evidence comparing prosthetic maintenance demands among different bar attachment systems remains limited. This pilot randomized clinical study aimed to compare the 5-year prosthetic complications and maintenance profiles of bar-locator versus bar-clip attachments to inform clinical attachment selection.
MATERIALS AND METHODS: Sixteen completely edentulous patients were rehabilitated with new maxillary and mandibular complete dentures and received two implants placed in the mandibular canine regions. Participants were randomly allocated to either a bar-locator group (n = 8) or a bar-clip group (n = 8). Prosthetic complications, including retentive component wear, screw loosening, tooth wear, denture fracture, relining, and other maintenance events, were clinically recorded over a 5-year follow-up period.
RESULTS: All participants completed the 5-year follow-up (100% retention). A total of 24 prosthetic complications were recorded in the bar-locator group and 13 in the bar-clip group. The mean number of complications per patient was 3.0 ± 1.3 for bar-locator and 1.6 ± 0.9 for bar-clip overdentures (absolute risk difference = +1.4; 95% CI: -0.3 to 3.0). Although the bar-locator group demonstrated numerically higher frequencies of retentive insert wear, tooth wear, and minor fractures, none of the between-group differences reached statistical significance (p > 0.05). No catastrophic mechanical failures were observed in either group.
CONCLUSIONS: Over 5 years, both bar-locator and bar-clip attachment systems demonstrated reliable mechanical performance and clinical longevity. The bar-locator system was associated with a higher overall maintenance burden. In contrast, bar-clip overdentures required relining more frequently, reflecting distinct long-term maintenance profiles rather than differences in durability. These pilot findings support the feasibility of a larger randomized trial and highlight the need for future studies incorporating patient-reported outcomes, cost-effectiveness analyses, and time-to-event assessments of prosthetic maintenance.
PMID:41765771 | DOI:10.1111/jopr.70115
