Clinical performance of LOCATOR® attachments: A retrospective study with 1-8 years of follow-up

The use of LOCATOR® attachments in implant-supported removable dental prostheses (ISRDPs) has been evidenced with conflicting clinical behavior in literature. This retrospective study aimed to investigate the long-term clinical performance of LOCATOR® attachments by evaluating the frequency of the encountered mechanical complication events (MCEs) and the factors that play a role in attachment wear (AW). The study recruited participants with ISRDPs on LOCATOR® attachments. Clinical parameters, number of MCEs (attachment replacements, attachment loosenings, denture cap-related events, loss of retention and/or insert, and implant fractures), and AW were recorded. Nonparametric tests were applied for statistical analyses (𝛼=0.05). Baseline demographics for the recruited 47 participants (mean age: 72.0 ± 9.0 years) revealed an implant survival rate of 94.9% (mean observation period: 54.8 months), average peri-implant probing depths, bleeding on probing scores, and plaque scores of 1.80 ± 1.50 mm, 0.70 ± 0.90, and 0.81 ± 0.90, respectively. MCEs were directly influenced by the time in use (p < 0.001). The most frequently encountered MCEs were loss of retention (p < 0.001) and denture cap-related complications (p = 0.004). AW was found to be significantly higher in the maxilla than in the mandible (p = 0.028); in the maxilla, the vestibular (p = 0.005) and mesial (p = 0.01) aspects were the most common wear sites. Maxillary implant overdentures revealed more vestibular AW (p = 0.013). In prostheses supported by >3 implants, vestibular (p = 0.046) and mesial (p = 0.032) AW were common. Lingual AW (p = 0.021) was observed more frequently when the support was <3 implants. Loss of retention and AW are the most common complications encountered with LOCATOR® attachments. Therefore, a modification in the attachment design along with an amelioration of the attachment surface may help decrease the maintenance needs and further enhance its clinical performance.