Randomized Clinical Trial Assessing Patient-reported Outcomes with Bar–Locator versus Bar–Clip Attachments in Mandibular Two-implant Overdentures

Abstract This randomized clinical trial compared patient satisfaction and oral health-related quality of life (OHRQoL) in edentulous individuals rehabilitated with mandibular two-implant overdentures retained by bar–locator or bar–clip attachments. A total of 16 edentulous participants received two implants in the mandibular canine regions and were randomly assigned to receive overdentures with either bar–locator or bar–clip attachments. Patient satisfaction was assessed using a 100-mm visual analog scale (VAS), and OHRQoL was measured using the Oral Health Impact Profile (OHIP-14) after 3 months of functional use. Independent samples t-tests were applied with a significance level of p < 0.05. Comparisons between the two attachment groups were performed using the independent samples t-test, and statistical significance was set at p < 0.05. In addition to p-values, effect sizes (Cohen's d) were calculated to assess the magnitude and clinical relevance of intergroup differences. The bar–locator group reported significantly higher satisfaction regarding denture stability, retention, and masticatory efficiency, whereas the bar–clip group demonstrated greater overall comfort and lower psychological discomfort scores. No statistically significant differences were found in other domains of satisfaction or OHRQoL. Both attachment systems improved patient satisfaction and OHRQoL, with each demonstrating distinct advantages. The bar–locator system provided superior functional performance, while the bar–clip system enhanced comfort and psychosocial adaptation. Clinical selection should be based on patient priorities and anatomical conditions.