A systematic review and meta-analysis of the attachments used in implant-supported overdentures

Aim: To evaluate the survival rate, tissue response, and patient satisfaction of different attachments used in implant overdenture. Settings and Design: Systematic Review and Meta-analysis. Materials and Methods: Electronic search of peer-review articles published between 2001 and 2019 assessing the attachments used for implant-supported overdentures was done according to PRISMA Guidelies. The review evaluated sixteen articles related to survival of the attachments, the reaction of the soft and hard tissues along with repair and maintenance of the attachments, and overall performance of the overdenture attachments. Statistical Analysis Used: There is statistically significant heterogeneity (Q =374.7403, df = 15, and P < 0.0001). The statistics of fixed-effect model reported an MD of - 0.0880 (95% CI = -0.1536; 0.0225). Result: The review evaluated the 16 articles that met with the inclusion and search criteria. The studies were the combination of bar and ball attachments and their subtypes, magnetic and bar attachments, and locator in combination with other attachments. The meta-analysis of combined 16 studies reported acceptable heterogeneity among 16 studies (I 2 = 96%) and reported to be statistically significant (P < 0.01). Conclusion: The survival rate of attachments was in the range of 95.8%-97.5% for bar, 96.2%-100% for ball, 90%-92% for magnet and locator attachments were in the range of 97% after a mean follow-up period of 3 years. The bar attachments reported moderate tissue reaction in the form of mucosal changes, gingival inflammation, and bone resorption. The locator attachments require higher maintenance and repair. The magnetic attachments produce higher bone resorption and readily displace under functional force. Patient satisfaction and compliance was higher for ball, locator, and bar attachments as well as low for magnetic attachment. Thus, the ball and locator attachments excellently perform in terms of survival rate, tissue response, and patient satisfaction.