Comprehensive Systematic Review of Breast Implant Illness: Symptoms, Management, and Long-Term Outcomes.

BACKGROUND: Breast augmentation using silicone implants is common, with over 300,000 annual US surgeries. It was initially approved in 1962, there were safety concerns with the use of silicone implants, leading to a 1992-2006 FDA moratorium. Recently, Breast Implant Illness (BII) was described as a cluster of symptoms associated with silicone implants, with a lack of diagnostic criteria, which increased the likelihood of implant removal and a variety of treatment options. This comprehensive review aims to shed light on the extent, symptoms, management, and outcomes of BII. METHODS: Multiple electronic databases were systematically searched in May 2023 for studies on Breast Implant Illness utilizing terms related to BII and its symptoms, diagnosis, and treatment. Out of 1204 studies, 20 met the inclusion criteria and were included in the systematic review. The Newcastle-Ottawa Scale for the included cohort prospective and retrospective studies, and the tool for evaluating the methodological quality of case reports and case series were utilized during quality assessment. RESULTS: There were 20 papers on Breast Implant Illness published between 1995 and 2022, including a peak of papers published in 2020 and 2022. The majority of the studies came from the USA, with a variety of research methods, including case reports. Reports of arthralgia and fatigue were common findings. These symptoms were frequently alleviated by surgical procedures such as en bloc explantation and capsulectomy, highlighting the intricacy of the problem and the need for individualized treatment plans. CONCLUSION: The review underscores the critical need for further research into BII, advocating for a multidisciplinary strategy that prioritizes patient safety, informed decision-making, and comprehensive care. As the medical community progresses in understanding and managing BII, emphasizing evidence-based practices and patient-provider communication will be essential in addressing this complex condition effectively. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Evaluation of Quality of Life and Satisfaction with Fixed Prostheses on Zygomatic Implants vs All-on-Four Concept: A Randomized Clinical Study.

AIM: To compare between the rehabilitation of atrophied maxilla with fixed prosthesis using two posterior zygomatic implants and two conventional anterior implants or four implants inserted according to the all-on-four concept regarding the patient quality of life and satisfaction after one year of prosthesis insertion. MATERIALS AND METHODS: Thirty-six patients with atrophic edentulous maxillae were randomized into two groups: Group I (rehabilitated with fixed prostheses supported by two zygomatic and two conventional implants in the anterior region) and group II (fixed prostheses on four implants in the anterior region following an all-on-four concept). One year after the placement of the definitive prostheses, patients completed oral health impact profile-14 and satisfaction questionnaires. RESULTS: All patients were satisfied regarding retention, stability, occlusion, comfort, cleaning, speaking, chewing, bolus quality, appearance, handling, prosthesis apart, and embarrassing, with no significant significance between two groups except satisfaction with surgical procedures and healing period. CONCLUSIONS: Using two distally tilted zygomatic implants or all-on-four concept to rehabilitate atrophied maxilla by fixed detachable prosthesis could be considered a promising functional and esthetic treatment option regarding the patient satisfaction. CLINICAL SIGNIFICANCE: Traditionally, treatment of maxillary atrophied ridges was done by bone grafting or sinus-lifting techniques; however, using all-on-four concept or zygomatic implants was a successful treatment as it has high success rates and highly satisfied by the patients. How to cite this article: Nagib MA, Ibrahim AM, Abdel-Rahman FH, et al. Evaluation of Quality of Life and Satisfaction with Fixed Prostheses on Zygomatic Implants vs All-on-Four Concept: A Randomized Clinical Study. J Contemp Dent Pract 2024;25(2):141-147.

Quality of Life After Bariatric and Body Contouring Surgery in the Australian Public Health System.

INTRODUCTION: The goals of bariatric surgery are weight loss, improved management of obesity-related diseases, and enhanced health-related quality of life (HRQoL). The aim of this study is to determine HRQoL among postoperative bariatric surgery patients. The aim of this study was to evaluate the utility of bariatric surgery and the role of body contouring surgery (BCS) when considering quality of life in low-volume centres in the Australian public health system. METHODS: This cohort study compared patients who underwent bariatric surgery between 2008 and 2018, to those awaiting surgery. An additional analysis was completed for patients who also underwent BCS. Patients completed the Short Form-36 quality of life (SF-36) survey. Linear regression was used to assess the differences in mean scores between cohorts for each of the SF-36 domains. RESULTS: A total of 131 postoperative patients were identified, with a follow up rate of 68%. The mean follow up was 5.4 y. The mean scores for all domains of the SF-36 in the postoperative group were higher than the preoperative group (P ≤ 0.0001). A significant difference in scores persisted after controlling for patients' current BMI. When considering patients who underwent BCS (n = 24), there was a further global improvement in HRQoL in physical function (P = 0.0065), role limitation to physical health (P = 0.0026), pain (P = 0.0004), energy (P = 0.0023) and general health perceptions (P = 0.0023). CONCLUSIONS: Bariatric surgery followed by BCS may improve HRQoL for the patient when compared to bariatric surgery alone. We advocate for the use of bariatric surgery followed by BCS in low-volume centres in the Australian public health system.

A Quantum Genetic Algorithm for Building a Semantic Textual Similarity Estimation Framework for Plagiarism Detection Applications.

The majority of the recent research on text similarity has been focused on machine learning strategies to combat the problem in the educational environment. When the originality of an idea is copied, it increases the difficulty of using a plagiarism detection system in practice, and the system fails. In cases like active-to-passive conversion, phrase structure changes, synonym substitution, and sentence reordering, the present approaches may not be adequate for plagiarism detection. In this article, semantic extraction and the quantum genetic algorithm (QGA) are integrated in a unified framework to identify idea plagiarism with the aim of enhancing the performance of existing methods in terms of detection accuracy and computational time. Semantic similarity measures, which use the WordNet database to extract semantic information, are used to capture a document's idea. In addition, the QGA is adapted to identify the interconnected, cohesive sentences that effectively convey the source document's main idea. QGAs are formulated using the quantum computing paradigm based on qubits and the superposition of states. By using the qubit chromosome as a representation rather than the more traditional binary, numeric, or symbolic representations, the QGA is able to express a linear superposition of solutions with the aim of increasing gene diversity. Due to its fast convergence and strong global search capacity, the QGA is well suited for a parallel structure. The proposed model has been assessed using a PAN 13-14 dataset, and the result indicates the model's ability to achieve significant detection improvement over some of the compared models. The recommended PD model achieves an approximately 20%, 15%, and 10% increase for TPR, PPV, and F-Score compared to GA and hierarchical GA (HGA)-based PD methods, respectively. Furthermore, the accuracy rate rises by approximately 10-15% for each increase in the number of samples in the dataset.

Devices measuring transepidermal water loss: A systematic review of measurement properties.

OBJECTIVE: The objective of this review is to examine the reliability and measurement error of devices that measure transepidermal water loss (TEWL). INTRODUCTION: TEWL is a physiological property of skin which increases when the epidermis is damaged. It is, therefore, a commonly utilised measure of skin barrier integrity. Devices measuring TEWL are available as open, semi-open or closed chamber. Studies of reliability examine the consistency of measurement, and/or responsiveness whereas measurement error scores in absolute terms the amount of error due to sources of variation. INCLUSION CRITERIA: Studies examining the reliability and/or measurement error of TEWL measurement devices were included. Studies that only report on measurement of TEWL outcomes without examination of reliability and/or measurement error were excluded. METHODS: The search strategy aimed to locate published and unpublished studies. Databases searched included PubMed, Embase, CINAHL and Web of Science, utilising identified keywords and limited to studies in English. Grey literature sources were searched to identify any unpublished documents. Study selection using the inclusion criteria was then assessed by two reviewers for methodological quality utilising the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias tool to assess the reliability and measurement error of outcome measurement instruments. RESULTS: A total of 22 devices were examined in the 38 included studies. The quality of study design was on average rated as 'Adequate' however reliability and measurement error statistical methods were on average rated as 'Doubtful'. DISCUSSION AND CONCLUSION: TEWL measurement devices were found to demonstrate good reliability and frequently correlated with other devices. However, measurement error was highly variable but improves under in vitro conditions. Future research should consider risk of bias factors when designing studies.

Pectin: A Bioactive Food Polysaccharide with Cancer Preventive Potential.

Pectin is an acidic heteropolysaccharide found in the cell walls and the primary and middle lamella of land plants. To be authorized as a food additive, industrial pectins must meet strict guidelines set forth by the Food and Agricultural Organization and must contain at least 65% polygalacturonic acid to achieve the E440 level. Fruit pectin derived from oranges or apples is commonly used in the food industry to gel or thicken foods and to stabilize acid-based milk beverages. It is a naturally occurring component and can be ingested by dietary consumption of fruit and vegetables. Preventing long-term chronic diseases like diabetes and heart disease is an important role of dietary carbohydrates. Colon and breast cancer are among the diseases for which data suggest that modified pectin (MP), specifically modified citrus pectin (MCP), has beneficial effects on the development and spread of malignancies, in addition to its benefits as a soluble dietary fiber. Cellular and animal studies and human clinical trials have provided corroborating data. Although pectin has many diverse functional qualities, this review focuses on various modifications used to develop MP and its benefits for cancer prevention, bioavailability, clinical trials, and toxicity studies. This review concludes that pectin has anti-cancer characteristics that have been found to inhibit tumor development and proliferation in a wide variety of cancer cells. Nevertheless, further clinical and basic research is required to confirm the chemopreventive or therapeutic role of specific dietary carbohydrate molecules.

Translation and Validation of American Diabetes Association Diabetes Risk Test: The Malay Version.

Background: Early detection of high-risk people for type 2 diabetes mellitus (T2DM) using a simple, non-invasive and cost-effective assessment tool helps to identify and prevent members of the community from developing this disease. Therefore, this study aims to translate the American Diabetes Association (ADA) diabetes risk test for Malaysians and then evaluate its validity. Methods: This cross-sectional study was conducted between March 2019 and April 2019. The instrument underwent forward and backward translation according to Behling and Law's technique. Content validity was performed by two experts and face validity was conducted among 35 convenience samples from Kota Bharu, Kelantan. Both were analysed using content validity index and face validity index, respectively. Results: All respondents were Malay, and had attained tertiary education with a mean (standard deviation [SD]) age of 20.63 (2.80) years old and BMI of 30.45 (5.99). Among the respondents, 57.1%, 94.3% and 80% were female, single and having a household income below RM1,500, respectively. The Malay translated instrument achieved high I-content validity index (CVI) [0.5-1.0] and S-CVI/Ave [0.93] as well as high I-face validity index (FVI) [0.86-0.97] and S-FVI/Ave [0.91] for understandability, and high I-FVI [0.77-0.91] and S-FVI/Ave [0.85] for clarity. Conclusion: The Malay version of the ADA diabetes risk test was found to be a valid survey instrument to be used for the Malaysian adult population.

'The newest vital sign among pregnant women attending women wellness and research Centre in Qatar: a cross-sectional study'.

BACKGROUND: Health literacy is a vital strategy to consider when designing health-promoting programs, and health literacy is a priority in Qatar's national health agenda. In the context of pregnancy, inadequate health literacy has been linked to several adverse outcomes among pregnant women such as unplanned conception, smoking, and lack of multi-vitamin intake. Given the paucity of data, this study aimed to assess the level of health literacy and its determinants among pregnant women in the State of Qatar. METHODS: An analytical cross-sectional design was utilized. First, we piloted the measurement tools on 10% of the calculated sample size. Accordingly, the items of the measurement tools were revised. Next, we utilized a structured questionnaire to interview the participants about their socio-demographic characteristics, pregnancy-related factors, and the Newest Vital Sign Tool. A chi-square test was employed to investigate the association level among variables, with significance set to P < 0.05. A logistic regression model was used to identify the factors associated with a low literacy level. RESULTS: We found that almost four in 10 pregnant women (n = 138,45.4%) had inadequate health literacy. Furthermore, the insufficient level of health literacy was significantly associated with low educational background, decreased household income, and primigravida. However, uncontrolled glycaemia was the only significant predictor of inadequate health literacy through logistic regression. The scale was found to be reliable, with a calculated Cronbach's alpha of 0.8. CONCLUSIONS: Low health literacy is common among pregnant women in the State of Qatar. Thus, public health officials should focus on delivering tailored health literacy interventions to pregnant women in the country.

Lactate clearance during the first 2 hours after hospital admission: A useful biomarker for predicting 30-day mortality in patients with diabetic ketoacidosis.

OBJECTIVE: This study assessed whether lactate clearance (LC) during the first 2 hours after admission to the emergency department can be used to predict the 30-day mortality of patients diagnosed with diabetic ketoacidosis (DKA). MATERIAL AND METHODS: This was a retrospective observational cohort study of patients admitted to the hospital between January 2014 and January 2019. We identified patients with diabetes who had blood gas test results at the time of admission and 2 hours thereafter. We then calculated the LC in these patients. Patients were divided into groups based on mortality and length of stay (LOS). The groups were compared in terms of age, blood gas pH, osmolarity, glucose level, lactate level on admission and 2 hours thereafter, LC, and bicarbonate (HCO3 - ), blood urea nitrogen, sodium, and potassium levels. RESULTS: The overall mortality rate was 7.54% (8/107). Age, pH, osmolarity, the HCO3 - , and sodium levels, the lactate level 2 hours after admission, and LC differed significantly between the groups (Mann-Whitney U test, P < .05). LC cut-off values and areas under the curve were significant (P < .05). Receiver operating characteristic analysis indicated an LC cut-off value of 18.6441; the area under the curve was 0.711 (P < .05). CONCLUSIONS: LC during the first 2 hours after admission is useful for predicting 30-day mortality in patients with diabetic ketoacidosis.

Erratum: Murthy et al. Phytochemicals and Biological Activities of Garcinia morella (Gaertn.) Desr.: A Review. Molecules 2020, 25, 5690.

The authors wish to make the following change to the funding section in their paper [1] [...].

Exogenous nitric oxide alleviates sulfur deficiency-induced oxidative damage in tomato seedlings.

Despite numerous reports on the role of nitric oxide (NO) in regulating plants growth and mitigating different environmental stresses, its participation in sulfur (S) -metabolism remains largely unknown. Therefore, we studied the role of NO in S acquisition and S-assimilation in tomato seedlings under low S-stress conditions by supplying NO to the leaves of S-sufficient and S-deficient seedlings. S-starved plants exhibited a substantial decreased in plant growth attributes, photosynthetic pigment chlorophyll (Chl) and other photosynthetic parameters, and activity of enzymes involved in Chl biosynthesis (δ-aminolevulinic acid dehydratase), and photosynthetic processes (carbonic anhydrase and RuBisco). Also, S-deficiency enhanced reactive oxygen species (ROS) (superoxide and hydrogen peroxide) and lipid peroxidation (malondialdehyde) levels in tomato seedlings. Contrarily, foliar supplementation of NO to S-deficient seedlings resulted in considerably reduced ROS formation in leaves and roots, which alleviated low S-stress-induced lipid peroxidation. However, exogenous NO enhanced proline accumulation by increasing proline metabolizing enzyme (Δ1-pyrroline-5-carboxylate synthetase) activity and also increased NO, hydrogen sulfide (a gasotransmitter small signaling molecule) and S uptake, and content of S-containing compounds (cysteine and reduced glutathione). Under S-limited conditions, NO improved S utilization efficiency of plants by upregulating the activity of S-assimilating enzymes (ATP sulfurylase, adenosine 5-phosphosulfate reductase, sulfide reductase and O-acetylserine (thiol) lyase). Under S-deprived conditions, improved S-assimilation of seedlings receiving NO resulted in improved redox homeostasis and ascorbate content through increased NO and S uptake. Application of 2-(4-carboxyphenyl)-4,4,5,5-tetramethylimidazoline-1-oxy l-3-oxide (an NO scavenger) invalidated the effect of NO and again caused low S-stress-induced oxidative damage, confirming the beneficial role of NO in seedlings under S-deprived conditions. Thus, exogenous NO enhanced the tolerance of tomato seedlings to limit S-triggered oxidative stress and improved photosynthetic performance and S assimilation.

Management of monochorionic twins discordant for structural fetal anomalies.

OBJECTIVE: To review the perinatal management and outcomes of monochorionic twin pregnancies (MC) discordant for congenital anomalies (DCA). METHODS: Retrospective, study of all MC DCA cases referred to our tertiary referral center from 1997 to 2018. We excluded cases complicated with twin-to-twin transfusion syndrome, twin anemia-polycythemia sequence, twin reversed arterial perfusion sequence or selective intra-uterine growth restriction. Patients were counseled about the possibility of expectant (EM) or interventional management (selective feticide [SF] or termination of the entire pregnancy [TOP]). RESULTS: One hundred eight of 4157 (2.6%) MC pregnancies were discordant for anomaly. Fifty two of 108 n(48.1%) underwent SF at a mean gestational age of 31.4 ± 5.9 weeks while 52/108(48.1%) opted for EM. Livebirth rate of the healthy co-twin was similar between the two groups (SF: 88.5% vs EM: 82.7%, P = .87). In the SF group, six healthy co-twins (6/52, 11.5%) died 5.3 ± 3.1 days after SF of the abnormal co-twin. In the EM group, in-utero demise of the abnormal twin occurred in 9 of 52 (17.3%) of the cases and was followed by the spontaneous demise of the healthy co-twin in 4 of 9 (44.4%) of these cases. CONCLUSION: Selective feticide does not seem to significantly alter survival of the healthy co-twin compared to EM.

Phytochemicals and Biological Activities of Garcinia morella (Gaertn.) Desr.: A Review.

Garcinia morella (Gaertn.) Desr. is an evergreen tree that yields edible fruits, oil, and resin. It is a source of "gamboge", a gum/resin that has a wide range of uses. The fruits, leaves, and seeds of this tree are rich in bioactive compounds, including xanthones, flavonoids, phenolic acids, organic acids, and terpenoids. Evidence from different studies has demonstrated the antioxidant, antifungal, antiviral, hepatoprotective, anticancer, anti-inflammatory, antibacterial, and larvicidal activities of the fruit, leaf, and seed extracts of G. morella. This review summarizes the information on the phytochemicals of G. morella and the biological activities of its active constituents.

Does determination of drug level in intoxicated patients offer an advantage in diagnosis, treatment, and reducing complications?

OBJECTIVE: To investigate the effect of determining the drug type and level on emergency management in patients presenting with intoxication, and to identify the factors behind associated mortality. METHODS: The retrospective, observational, cross-sectional and single centre study was conducted at a large tertiary care teaching hospital in Istanbul, Turkey, between September and November 2016 using the hospital's toxicology registry. Data was extracted for patients who had presented to the emergency department from January 1, 2011, to February 28, 2013, and were found to have toxic doses of single active ingredients in the plasma. The patients were evaluated in terms of age, gender, demographic characteristics, time from ingestion to presentation, reason for drug ingestion, type of drug ingested, time elapsed before the emergency service was called, treatment given, drug level, hospitalisation and mortality. Data was analysed using SPSS 11.5. RESULTS: Of the 224 patients, 145(64.8%) were women. The overall mean age was 30.8±15.4 years. Drug ingestion was more common in women aged 18-30 years (p<0.0001). Besides, 215(96%) patients had ingested drugs with the intent to commit suicide. The minimum education level of 163(72.8%) patients was high school. The most frequently ingested drug was paracetamol 90(40.2%). Overall mortality was 4(1.8%) and all of them were brought to the emergency department after a delay of more than five hours (p<0.0001). CONCLUSIONS: Drug type and quantity were found to be of great importance in taking timely decisions while attending to patients with intoxication in an emergency setting. Delay in presentation was associated with mortality..

Potential roles of melatonin and sulfur in alleviation of lanthanum toxicity in tomato seedlings.

Owing to the active use of rare-earth elements in many areas, it is necessary to study their behavior in the environment and their biological impact on plants. Despite the role of melatonin and sulfur in plant growth, development and abiotic stress tolerance; it is still not clear how they have a strong regulatory influence and synergistic effect on growth, physiological and biochemical characteristics of plants under different environmental stresses. Therefore, this study highlights how melatonin and sulfur together potentially involved in a reversal of lanthanum-inhibited photosynthetic and growth responses in tomato seedlings. Here, we reported that seedlings grown in a medium containing 150 µM lanthanum exhibited increased overproduction of reactive oxygen species (ROS) and lipid peroxidation together with increased Chlorophyll degradation, and activity of chlorophyllase, proline dehydrogenase and glycolate oxidase (GOx), and decreased photosynthesis and growth. However, the application of melatonin and sulfur showed significant responses on tomato seedlings, although the response of their combined treatment was more effective by further increasing photosynthesis and growth under lanthanum toxicity. Melatonin supplied with sulfur suppressed ROS formation, lipid peroxidation and activity of GOx, and increased photosynthesis by upregulating activities of carbonic anhydrase and ribulose-1,5-bisphosphate carboxylase/oxygenase. Also, sulfur supplementation with melatonin to seedlings resulted in an elevation in the accumulation of Chl and proline by increasing δ-aminolevulinic acid and activity of δ-aminolevulinic acid dehydratase and Δ1-pyrroline-5-carboxylate synthetase activity. The administration of melatonin with sulfur substantially induced upregulation of enzymes (superoxide dismutase, ascorbate peroxidase, monodehydroascorbate reductase, dehydroascorbate reductase and glutathione reductase) activities involved in the antioxidant system, thereby mitigating ROS-induced oxidative damage. Thus, this study provides strong evidence that melatonin and sulfur have strong regulatory influence and synergistic role in alleviating the adverse effect of lanthanum-toxicity by increasing photosynthesis and growth.

Expectant management of caesarean scar ectopic pregnancy: a systematic review.

AIM: The purpose of this review is to systematically review all the reported cases and case series of caesarean scar pregnancy (CSP) managed expectantly without any intervention in order to understand the outcomes of pregnancy which will guide clinicians and patients in making treatment choices. METHODS: An electronic search on PubMed, EMBASE and Cochrane databases and a manual search from references of the articles were performed. Studies were selected based on inclusion and exclusion criteria. Data were extracted for various outcomes of pregnancy and the quality of the reports was assessed using a modified Delphi technique. RESULTS: A total of 56 cases of CSP from 11 reports were included in the review, including 44 cases with foetal cardiac activity. Live births were achieved in 73% of cases with a quarter of them born before 34 weeks. Hysterectomy rates were 70%. In 12/44 (27%) of cases pregnancies were lost due to complications before 24 weeks. Most (67%) of the CSPs with no foetal cardiac activities resolved on expectant management and the remaining required intervention for bleeding. CONCLUSIONS: Caution should be exercised when choosing expectant management in cases of viable CSPs, and if chosen, the patient should be counselled adequately for possible outcomes including loss of pregnancy and hysterectomy. Expectant management is acceptable in CSPs with no foetal cardiac activity. There is a need for prospective research on this topic with adequate reporting on possible prognostic markers, as well as a need to improve on the techniques to prevent loss of fertility during delivery.

Anencephaly and obstetric outcome beyond the age of viability.

Objective To review the obstetric impact and natural history of anencephalic pregnancies beyond the age of viability. Study design A retrospective chart review of all cases with a prenatal diagnosis of anencephaly who delivered after 24 weeks' gestation during the period 1990 until 2016. Obstetric outcomes including mode of delivery, live births, shoulder dystocia, antepartum haemorrhage (APH), postpartum haemorrhage (PPH) and uterine rupture were studied. Results A total of 42 cases were studied. The average gestational age at diagnosis was 22 weeks (range 10-41). The average gestational age at birth was 36 weeks (range 25-44 weeks). Induction of labour was performed in 55% (23/42) of the cases. Livebirths were documented in 40% (17/42) of the cases. The average birth weight was 1597±746 g. The rate of vaginal birth was 69% (29/42), the overall rate of caesarean section was 31% (13/42), with a primary caesarean section in 31% (4/13) and a repeat caesarean section in 69% (9/13) of the patients. There were two cases of shoulder dystocia. No other complications were encountered. Conclusion Overall, anencephaly is not associated with an increased risk of obstetric complications; however, there is a tendency towards delivery via repeated caesarean section in women with a previous uterine scar and anencephaly. The prenatal counselling of potential obstetric outcomes could be of robust value for parents who opt to continue with anencephalic pregnancies.

Effect of bar cross-section and female housing material on retention of mandibular implant bar overdentures: A comparative in vitro study.

AIM: The aim of this study is to evaluate the effect of different cross-sections of bar connecting two implants on the retention of mandibular overdentures with Hader clip or lined with heat-cured resilient liner as a housing material. The retentive values after simulated 1.5 years of service were also recorded. MATERIALS AND METHODS: Edentulous mandibular acrylic model was constructed with two dummy implants located in the canine region and connected with cast bar assembly. According to bar cross-section and anchoring method, four groups (n = 10) of identical overdentures were used as Hader bar/clip group (HCG), Hader bar/silicone liner female housing group (HSG), oval bar/silicone liner female housing group (OSG), and round bar/silicone liner female housing group (RSG). Each overdenture sample was subjected to simulated wear up to 2740 manual insertions/separations. The mean retentive forces were measured at the baseline and after every 500 insertions. The data were statistically analyzed using one-way analysis of variance. RESULTS: The present study demonstrated that all bar cross-sections showed a significant difference at the baseline (P < 0.05), but HSG showed greater initial retention compared to HCG, OSG, and RSG. OSG showed a significant higher retention after 2740 insertions (simulated five insertions/day). CONCLUSIONS: Within the limitation of this in vitro study and for a similar period of service, heat-cured silicone female housing for Hader bar could maintain greater retention for two-implant-retained overdentures than provided by conventional plastic clip after 1.5 year. The oval bar recorded reasonable initial retention values and maintained these values for 1.5 years of service.