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| Authors | Year | No. of patients | No. of follow-up years | Types of attachments | Attachment types with better performance | Implant manufacturer | Implant types | Maxillary arch | Loading protocols | OHIP-14 | Satisfaction | Comfort | Speech | Appearance | Chewing ability | Denture stability/ retention | Postinsertion maintenance |
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| Bilhan et al. [40] | 2011 | Self-aligning abutments, n = 13
Ball abutments, n = 12 | 3 months for each attachment | Self- aligning vs ball | Self-aligning attachments are comparable to ball attachments in OHRQL and may be superior in cases of reduced space for attachment placement. | Osseospeed, Astra Tech | Standard 4.5 x 13 mm | Complete denture | Early (6 weeks after surgery) | All: no diff
Below average space: ball > self | Nil | Nil | Nil | Nil | Nil | Nil | Nil |
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| Krennmair et al. [41] | 2012 | Locator, n = 10
Crossover trial after 3 months | 3 months for each attachment | Locator vs ball | No differences between ball or Locator attachment for any items of satisfaction evaluated and neither attachment had a significant patient preference
Locator attachment required more postinsertion aftercare (activation of retention) than the ball anchors (nonsignificance) | Camlog, Screw-Line, Altatec | Standard | Complete denture | Delayed (3 months and 2 weeks) | Nil | No diff | No diff | No diff | No diff | No diff | No diff | No diff |
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| Krennmair et al. [42] | 2011 | Ball, n = 13
Telescopic crown, n = 12 | 5 years | Ball vs telescopic | Frequency of technical complications was initially higher with ball attachments than with resilient telescopic crowns over a 5-year period | Camlog, Screw-Line, Altatec | Standard | Complete/ partial | Delayed (3 months) | Nil | No diff | n#il | No diff | No diff | No diff | No diff | Ball > telescopic; significantly more matrix repairs and activation |
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| Cepa et al. [43] | 2017 | Ball, n = 12
Conus, n = 13 | 3 years | Ball vs conus | High dissatisfaction with the conus attachment resulted in numerous patients refusing to further participate in the study
Except the deceased participants, all patients stayed with the ball attachment system, whereas only 7 of 11 patients stayed with the conus system
Therefore, the investigated conus attachment system cannot be recommended | Ankylos, Dentsply, Germany | Standard | All three forms accepted | 3 months | Nil | Higher with ball than conus | Nil | Nil | Nil | Nil | Nil | Nil |
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| Jawad et al. [44] | 2017 | Standard, n = 22
Mini, n = 20 | 6 months | Mini-ball vs standard ball | No difference between both attachments | Mini-3M Standard-Astra Tech | Standard vs mini | Complete denture | 2 months | Similar scores in both groups | No diff | No diff | No diff | Nil | No diff | No diff | Nil |
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