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Issue: 04/2011 - M. Wolkewitz - B. Koller - S. Cepa - R. Kohal
Implant-retained prostheses: ball vs. conus attachments – A randomized controlled clinical trial

Purpose: The aim of the present study was to evaluate implant survival, peri-implant soft and hard tissue conditions, prosthodontic maintenance and patient satisfaction for implant-supported mandibular overdentures retained with ball attachments or prefabricated conical crown attachments during a 2-year period.

Materials and methods: 25 patients with edentulous mandibles received two oral implants in the mandibular interforaminal region. The denture attachment system was chosen randomly. Twelve patients received ball attachments and 13 patients received prefabricated conical crown attachments. Implant survival, peri-implant soft and hard tissue conditions such as probing depth (PD), modified plaque index (mPlI), bleeding on probing (BOP), modified gingival index (mGI), horizontal bone loss (HBL) and patient satisfaction were assessed for each patient. In addition, detailed prosthodontic maintenance interventions were monitored during the follow-up period.

Results: The implant survival rate was 100%. There were no significant differences in PD, mPlI, BOP, mGI and HBL between the two groups. Within the two-year evaluation period prosthodontic intervention was required for 80% of the patients in the ball attachment group and 75% of the patients in the conical crown group. After two years, patient satisfaction in the ball group (82%) was higher than in the conical crown group (60%).

Conclusion: The results indicate that both attachments (ball attachment, conical crown attachment) used on two implants in the edentulous mandible show similar clinical results. However, the maintenance of both attachment groups is high. Due to the need for extensive maintenance, regular recall is fundamental for both attachment systems.

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