Cleansability of and patients' satisfaction with implant-retained overdentures: a retrospective comparison of two attachment methods

BACKGROUND: Two important factors in the use of implant-retained overdentures are cleansability and patients' satisfaction. Limited research has been published concerning the cleansability of these overdentures On the other hand, studies have compared patients' satisfaction with conventional dentures and various designs of implant overdentures. However, no studies have compared overdentures retained by Hader bars (Sterngold, Attleboro, Mass.) and direct ERA attachments (Sterngold) in terms of both cleansability and patients' satisfaction. PURPOSE: The authors' aim was to determine the cleansability of and patients' acceptance of overdentures retained by direct ERA attachments and overdentures supported by a Hader bar with distal ERA attachments and a Hader clip. MATERIALS AND METHODS: Two groups of 10 subjects each were evaluated: Group A, consisting of patients with overdentures retained by direct ERA attachments, and Group B, consisting of patients with overdentures retained by Hader bars. The authors evaluated the subjects between 18 and 24 months after the delivery of the overdentures by means of a questionnaire and a clinical examination to score each patient on gingival, plaque and calculus indexes. RESULTS: Group A exhibited better results than Group B on calculus, plaque and gingival indexes, but the difference was not statistically significant. The authors found no significant difference between the two experimental groups in satisfaction. CONCLUSIONS: When evaluated in terms of subjects' satisfaction and calculus, plaque and gingival index scores, implant-retained overdentures supported by direct ERA attachments were similar to those supported by a Hader bar. CLINICAL IMPLICATIONS: The two types of overdentures studied are equally satisfactory and easy to clean. Other factors such as biomechanics, patients' preference and previous experience may be more critical when selecting the retention design for an overdenture supported by four implants.