Evaluation of locator versus TITACH attachments for mandibular 2-implant overdentures: a one-year randomized controlled clinical trial.

Implant overdenture attachments serve as the crucial link between dental implants and removable dentures, significantly enhancing the stability, retention, and function of the prosthesis. This study was designed to assess the effectiveness of locator and TITACH attachments in retaining mandibular two-implant overdentures, maximum bite force, and marginal bone loss. The study involved 36 edentulous patients, each receiving new complete dentures (CDs) designed with the bilateral balanced occlusal concept. Two implants were positioned in the mandibular canine regions. Participants were randomly assigned to two equal groups: Group I (LOA) with overdentures using locator attachments, and Group II (TIA) with overdentures using TITACH attachments. Retention and maximum bite forces were measured using a digital force meter and bite force transducers at baseline (T0), and at 6 months (T6), and 12 months (T12) post-insertion. After insertion, marginal bone loss (MBL) was evaluated using digital periapical radiographs at T6 and T12. Retention significantly decreased over time across all groups (p = 0.024 for CD, p < 0.001 for LOA and TIA). Maximum bite forces significantly declined for LOA (p = 0.007) and TIA (p = 0.003) at all measurement intervals. TIA demonstrated the highest retention and bite forces, followed by LOA, while CDs exhibited the lowest retention and bite forces. TIA was associated with significantly greater MBL than LOA (p = 0.002 and p < 0.001 for TIA). TITACH attachments showed superior retention and maximum bite force compared to locator attachments. Both attachment types offered improved retention and maximum bite forces relative to complete dentures. Additionally, locator attachments were associated with less peri-implant bone loss than TITACH attachments.