title: Prosthetic aspects and patient satisfaction with resilient liner and clip attachments for bar- and implant-retained mandibular overdentures: a 3-year randomized clinical study.
abstract: OBJECTIVE
  This report aimed to compare prosthetic aspects and patient satisfaction during a 3-year randomized clinical trial of bar- and implant-retained mandibular overdentures attached with either resilient liners or clips.
  
  
  METHODS
  Thirty edentulous male patients (mean age: 62.5 years) received two implants in the anterior mandible after being allocated into two equal groups (according to attachment type received) using balanced randomization. After 3 months, implants were connected with resilient bars. New maxillary complete dentures were then constructed, and mandibular overdentures were retained to the bars with either clips (group I) or silicone resilient liners (group II). Subjects indicated satisfaction with their prostheses using a questionnaire and visual analog scale. Patient satisfaction and prosthetic complications were recorded for both attachments at 6 months and 1 and 3 years after overdenture insertion.
  
  
  RESULTS
  Comfort and stability with the maxillary denture and ease of hygiene procedures were rated higher in group II, while ease of handling the dentures was rated higher in group I. No significant differences in other parameters of patient satisfaction between groups were noted after 3 years. The mean number of prosthetic adjustments and repairs in group I (11.9) was significantly higher (P = .00) compared to that in group II (4.8). The most common complication in group I was clip wear, while separation of the resilient liner from the denture base was the most common problem in group II. Hyperplasia under the bar and flabby ridge in the maxilla occurred significantly more often in group I compared to group II.
  
  
  CONCLUSIONS
  Resilient liner-retained mandibular overdentures had comparable patient satisfaction, less prosthetic maintenance and costs, and less soft tissue complications when compared to clip-retained ones after 3 years.
authors.affiliation: Mansoura University, Eldakahlia, Egypt. M_syad@mans.edu.eg
authors.forename: Moustafa Abdou
authors.initials: MA
authors.lastname: ELsyad
mesh_terms: D019094:Dental Prosthesis, Implant-Supported / Q000523:psychology*; D019232:Dental Restoration Failure; D019554:Dental Restoration Wear; D003822:Denture Liners; D003780:Denture Repair; D003781:Denture Retention / Q000295:instrumentation*; D003826:Denture, Complete, Lower / Q000523:psychology*; D003828:Denture, Overlay / Q000523:psychology*; D004435:Eating / Q000502:physiology; D004955:Esthetics, Dental; D005500:Follow-Up Studies; D005885:Gingival Hyperplasia / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene; D019226:Oral Ulcer / Q000209:etiology; D017060:Patient Satisfaction; D013060:Speech / Q000502:physiology; D013282:Stomatitis, Denture / Q000209:etiology; D016896:Treatment Outcome