# Evaluation of retention of TiTach versus ball and socket attachments used in mandibular implant-retained overdentures: a comparative in vitro study

## TL;DR

This study compares the retention of TiTach and ball and socket attachments in mandibular overdentures, finding TiTach provides higher and more stable retention.

## Contribution

The study introduces and evaluates the novel TiTach attachment system for mandibular overdentures in an in vitro setting.

## Key findings

- TiTach attachments showed significantly higher retentive force before and after cyclic loading compared to ball and socket attachments.
- TiTach attachments exhibited a lower percentage decrease in retentive force after cyclic loading than ball and socket attachments.
- Both attachment types experienced a statistically significant decline in retentive force after cyclic loading.

## Abstract

For the edentulous mandible, removable prostheses that are held in place by implants are great solutions because they offer good retention with various attachments. A novel attachment system that supports an alternative kind of connection is called TiTach. Few studies have investigated this type of attachment. This study compared the retention of TiTach attachments with ball and socket attachments used for overdentures retained by mandibular implants.

Two ready-made epoxy models were used representing the edentulous mandible and two implants at the canine site with zero inclination were installed. Eight pairs of attachments were used for each model. For the first group, ball and socket attachments were used while for the second group, TiTach attachments were used. Cyclic loading with 1000 insertion and removal cycles was done. Retentive force prior to and following cycles of insertion and removal was measured using the universal testing machine. The Mann Whitney U test and the independent t test were used to compare the groups. Differences in retention values before and after cyclic loading were analyzed using paired t test.

The TiTach group displayed significantly higher retentive force values before cyclic loading (41.68 ± 6.19) and after cyclic loading (30.21 ± 6.78) compared with the ball and socket group before cyclic loading (5.44 ± 0.84) and after cyclic loading (3.20 ± 0.54), respectively (P < 0.0001). Both groups exhibited a statistically significant decline in retentive force after cyclic loading (P < 0.0001). Retention loss in the ball and socket group is 2.35 (from 5.41 to 3.06), representing a 43.44% decrease, while retention loss in the TiTach group is 10.30 (from 40.90 to 30.60), representing a 25.18% decrease.

Higher initial and final retentive force as well as a beneficial lower percentage change in retentive force were demonstrated by the TiTach attachment compared with the ball and socket attachment. The TiTach attachment could be a suitable choice when increased retention is required.

The online version contains supplementary material available at 10.1186/s12903-025-07056-1.