Sys Rev Pharm 2020;11(9):15-19 A multifaceted review journal in the field of pharmacy 15 Systematic Reviews in Pharmacy Vol 11, Issue 9, Sept-Oct 2020 Locator or Ball Attachment Systems for Mandibular Implant Overdentures: A Systematic Review Muhammad Ikbal, Acing Habibie Mude, Irfan Dammar, Vinsensia Launardo, Ian Afifah Sudarman Department of Prosthodontic, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia. Corresponding Author: ikbal_muhammad@unhas.ac.id ABSTRACT The aim of this study is to lecture treatment results award to attachment systems for mandibular implant overdentures in terms of prosthesis retention, marginal bone loss to the implant and patient satisfaction, between locator and ball attachment system. This systematic review was conducted using Wiley and PubMed of match journals regarding inclusion and exclusion criteria. Clinical trial studies on mandibular implant overdentures from January 2009 to November 2019 were chosen 10 articles from 125 articles were lastly included and the data on prosthesis retention, marginal bone loss and patient satisfaction were analyzed similar to attachment systems. From the limited amount of research, the model of attachment did not show a significant difference between marginal bone loss and implant patient satisfaction measure. but, overdentures with locator attachment tend to have a higher retention than the attachments ball. The conclusion is that the locator and the ball attachment system present the same clinical performance on marginal bone loss and patient satisfaction, but the locator attachment has a higher retention than the ball attachment. Keywords: Attachment systems, Ball attachment, Implant overdentures, Locator attachment Correspondence: Muhammad Ikbal Department of Prosthodontic, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia. Corresponding Author: i kbal_muhammad@unhas.ac.id INTRODUCTION Patients with edentulous tooth complaints can have great difficulty using their conventional dentures because of the stability, support, retention bolts, and associated compromise in ability and comfort when chewing. 1 Overdenture use of mandibular implants has been done in many studies and found to be simpler and more economical the cost of a fixed prosthesis implant. 2 Overdenture of two implants in mandibular complete maxillary dentures is the primary choice for management of full edentulous patients. 3 To increase stability and retention of dentures, an excess attachment system can be used for cases of mandibular implant overdenture. 1 Different attachment systems used to design prosthetic un-splinted of mandibular implant overdentures. in general, gold alloy matrices standard 2.25mm ball attachments are used with documented positive results. Recently, the spread out utilize of the Locator attachment system has become modern. 4 In 2001, the attachment system Zest Anchors Company® attachment systems empower one of the most famous Locator, with a design optimized for the purpose of reforming storage and stability provided by the ball-type attachment. This system consists of Patrix (for men) and matrix (for women). It is classified as a strong universal hinge device and is designed for a limited distance between the arches, allowing the angle between the implants increased to 40º. 5 Mostly, the attachment system depends on practitioners' events and preferences. from several studies that have been conducted comparing various attachments in ways that are useful for clinical decision making. and also, research on systematic review articles has shown how long the implant lasts, 6 complications in prosthetic 7 and Overdenture patient satisfaction 8 of the mandible without comparison the attachment system. Therefore, a systematic review of the implant overlay system is needed to focus on the published results. The aim of this review is the outcome of treatment depends on the attachment system for overdenture of the mandibular implant associated with prosthesis retention, marginal bone loss to the implant and patient satisfaction between the locator and ball attachments. MATERIAL AND METHOD This study was written in accordance with PRISMA guidelines (Selected Reporting Items for Systematic Review and Meta-Analysis) to report studies evaluating health care interventions. 9 The PICO format (Population, Intervention, Comparison, Results) is used to show clinical questions with obvious inclusion criteria. 10 Questions characteristics and criteria for inclusion are clinical studies involving full Overdenture edentulous mandibular implant (P) opposing maxillary complete dentures conventional (I). Studies were selected and then divided further by the Overdenture attachment system (especially ball and locator attachment) used (C). 1) attachment retention; 2) bone loss marginal to the implant; and 3) patient satisfaction (O) evaluated. Search Strategy This systematic review search uses an implanted overdenture of the MeSH browser " and "Attachment systems" and "overdentures" and "ball attachment" and "locator attachment", and limited by "Human", "English" and the publication dates is 10 years in the database. The electronic search was also conducted using Wiley with the same keywords. Manual search of full text articles and related reviews is done afterwards. Eligibility Criteria The inclusion and exclusion criteria in this systematic review were the following: Inclusion Criteria were randomized clinical trials (RCT) and clinical trial studies on overdenture of mandible and maxillary implants from January 2009-November 2019, the comparative study between attachment in