Attachment-Retained Unilateral Partial Denture versus Tooth Implant-Supported Prosthesis in Mandibular Distal Extension Cases: A Randomized Controlled Trial

Mohamed Sharaf1, *, Asharaf Eskander2
1 Department of Prosthetic, University of Menoufia, Al Minufiyah, Egypt
2 Department of Prosthetic, Cairo University, Giza, Egypt

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© Sharaf and Eskander

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Prosthetic, University of Menoufia, Al Minufiyah, Egypt; Tel: 01223095900;



To evaluate patients’ satisfaction, biting force measurement, and radiographic evaluation of abutment teeth of tooth implant-supported fixed partial denture, unilateral attachment, and conventional partial denture in mandibular distal extension cases.

Materials and Methods:

Twenty-four participants were selected according to the following criteria: participants with unilateral mandibular distal extension with last standing second premolar abutment; participants having abutments with sufficient occluso-gingival height and good periodontal condition. Participants were divided into the following three equal groups: participants of the implant group received fixed tooth implant-supported fixed partial dentures, attachment group participants received unilateral attachment removable partial dentures, and conventional group participants received conventional removable partial dentures. The evaluation included patient satisfaction using “OHIP14” questionnaires, biting force measurement, and radiographic evaluation of terminal abutments using the ANOVA test.


Participants of the implant group were mainly satisfied with their prosthesis than the attachment group, which is higher than the conventional. Regarding biting force measurement, there is a statistically significant difference (p < 0.05) between all groups, including the implant group and attachment group, as well as between attachment and conventional group (p < 0.05). The conventional group showed statistically significant (p < 0.05) highest mean bone loss, while there was no statistically significant difference between implant and attachment groups; both showed statistically significantly lower mean amounts of bone loss.


The tooth implant-supported fixed prosthesis could be considered a superior line of treatment for managing distal extension cases. Unilateral attachment, which is considered an excellent alternative in the case of implant placement, is not recommended.

Keywords: Biting force, Distal extension, Implants, Partial denture, Tooth implant connection, Unilateral attachment.