Abstract:
Objectives: The aim of this was to compare the influence of two different angulated
abutment designs on patient satisfaction, oral health-related quality of life, and pros-
thetic aspects of implant-supported maxillary overdentures.
Materials and Methods: For this cross-over study, 18 patients with completely edentu-
lous maxillary ridges opposing implant-retained mandibular overdentures received
4 implants between the maxillary sinuses using computer-guided surgery. The anterior
implants were installed at canine/lateral incisor areas and inclined 15 labially. The pos-
terior implants were inserted just anterior to the maxillary sinuses and inclined 15o dis-
tally. Eight patients received maxillary overdentures retained by angled ball attachment
(ball overdenture [BOD]) and angled locator attachment in random order. After
6 months, patients indicated satisfaction with their prosthesis using a visual analog scale
(VAS), and oral health impact profile (OHIP-14). Moreover, postinsertion prosthodontic
maintenance and complications were recorded for both attachments. Comparisons of
patient satisfaction and prosthetic complications between groups were performed using
the Wilcoxon matched-pairs test and the McNemar test, respectively.
Results: Locator overdenture (LOD) recorded significantly higher scores than the
BOD group regarding all the VAS questions except for ease of cleaning (p < 0.007).
LOD recorded significantly higher patient satisfaction regarding the pronunciation of
sounds (p = 0.009), painful aching (p = 0.018), feeling tense (p = 0.011), unsatisfac-
tory diet (p = 0.013), irritability with people (p = 0.005), and life in general
(p = 0.004). The most common complications were matrix activation/renewal
(n = 34). BOD showed a significantly higher incidence of attachment loosening
(p = 0.002), and teeth fracture (p = 0.049) than LOD. LOD showed a significantly
higher incidence of attachment wear and replacement than BOD (p <0.001). There
was no difference between groups regarding soft tissue complications.
Conclusion: Within the limitations of this study, and in terms of improved patient-
centered outcomes, angled locator attachments are recommended to retain maxillary
implant overdentures opposed by implant retained mandibular overdentures at it was associated with increased patient satisfaction and oral health-related quality of life
than angled ball attachments. However, locator attachment was associated with
more postinsertion prosthodontic maintenance than ball attachment.