Maxillary implant-retained overdentures: telescopic versus LOCATOR attachments

A Commentary on Ibrahim WI, Abdeen RM, Denewar MM, Kortam SA . Retention of telescopic versus LOCATOR attachments and marginal bone loss surrounding implant-retained maxillary overdentures: A 2-year randomized clinical trial. J Prosthet Dent . 2026;135:778–786. Design Prospective two-arm parallel randomised controlled trial (RCT) comparing telescopic and LOCATOR attachments for four-implant retained maxillary overdentures over 24 months. Case selection 40 patients with complete edentulism received four maxillary implants to retain a maxillary overdenture and two mandibular implants to retain an opposing mandibular overdenture. Patients were randomly allocated to telescopic or LOCATOR maxillary attachment groups. Inclusion criteria included adequate maxillary bone volume and quality, suitable inter-arch space, acceptable systemic health and absence of parafunctional habits or conditions affecting osseointegration. Data analysis Retention was measured using a digital force gauge at R0, one month after prosthesis delivery, and at 12 and 24 months. Vertical and horizontal marginal bone loss were assessed using standardised periapical radiographs and digital software. Between- and within-group comparisons were performed using t tests with Bonferroni correction. Results Telescopic attachments showed significantly greater retention than LOCATOR attachments at all time points. Telescopic retention decreased from 28.59 N to 15.63 N over 24 months, while LOCATOR retention increased slightly at 12 months before decreasing to 9.44 N. Marginal bone loss was significantly greater in the telescopic group at 12 and 24 months. One implant failed in the telescopic group. Conclusions Telescopic attachments provided greater retention, whereas LOCATOR attachments were associated with less marginal bone loss. Both systems remained within accepted implant success thresholds over two years.