Clinical outcomes of a Locator-bilateral segmental bar concept versus a conventional rigid bar concept for maxillary implant-supported overdentures: a retrospective cohort study
摘要
This retrospective cohort study evaluated a Locator-bilateral segmental bar concept (LBSB) for maxillary implant-supported overdentures and compared it with a conventional rigid bar concept (CRB) in terms of implant survival, peri-implant conditions, marginal bone loss (MBL), complications, and numeric rating scale (NRS)-based satisfaction.
MethodsConsecutive patients treated between January 2013 and December 2025 were reviewed. Eligible patients had been treated using either the LBSB or CRB concept. Outcomes included implant survival, MBL, modified sulcus bleeding index (mSBI), modified plaque index (mPI), time-to-first complication, NRS-based overall patient satisfaction (primary outcome), and seven domain-specific satisfaction items. Between-group associations were assessed using regression models adjusted for follow-up duration; complications were analyzed using Kaplan-Meier methods and Firth-penalized Cox models.
ResultsNineteen patients were included (LBSB, n = 10; CRB, n = 9), with mean follow-up durations of 5.10 ± 3.07 and 5.67 ± 3.54 years, respectively. Implant and prosthesis survival were 100% in both groups. In adjusted analyses, the LBSB group showed lower MBL than the CRB group (adjusted mean difference, − 0.310 mm; p = 0.007), whereas mSBI and mPI did not differ significantly. Kaplan-Meier curves for any complication were comparable between groups (log-rank p = 0.860), while the LBSB group showed a lower estimated hazard of relining (HR, 0.056; Holm-adjusted p = 0.019). Overall satisfaction scores appeared higher in the LBSB group, with an adjusted mean difference of 0.983 (p = 0.031).
ConclusionsWithin the limitations of this small non-randomized retrospective cohort, the LBSB concept was associated with lower MBL, an estimated lower hazard of relining, and higher NRS-based satisfaction compared with the CRB concept. These findings should be interpreted as exploratory, hypothesis-generating concept-level associations, rather than as evidence of clinical superiority or causal effects of any individual design component. Confirmation in adequately powered prospective studies is warranted.