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The latters were randomized based on the healing protocol and the used attachments into 4 equal groups: Submerged healing with ball attachment (BS), submerged with CM-LOC attachment (CS), non-submerged with ball attachment (BN), and non-submerged with CM-LOC (CN). Standardized peri-apical radiographs at baseline, 12 and 24\u00a0months were recorded to measure MBL. Comparisons for numerical data were performed using either Mann Whitney-U or Kruskal Wallis tests. Binary and categorical data were compared using chi square test. Significance level was set at\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During the healing period, 6 implants failed, and 4 drop-outs were recorded. At the second year, 27\/34 ball groups and 28\/36 CM-LOC groups were recalled, no significant difference between B (0.28\u2009\u00b1\u20090.44) and C (0.38\u2009\u00b1\u20090.46) favoring B group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.3), and N (0.27\u2009\u00b1\u20090.39) and S (0.43\u2009\u00b1\u20090.51) favoring N group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.6). MBL revealed no significant difference neither between B and C groups nor between N and S groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both attachments showed physiologically accepted limits of MBL, favoring the non-submerged healing protocol after a 2-year follow-up period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical relevance<\/jats:title>\n                    <jats:p>Submerged (S) and Non-submerged (N) protocols could be used for a SIMOR, favoring the N protocol after a 2-year follow-up.<\/jats:p>\n                    <jats:p>Trial registration number: PACTR20183003085193.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00784-025-06617-6","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T02:20:58Z","timestamp":1764901258000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Marginal bone loss in single implant-retained mandibular overdentures using two different healing protocols and two different types of attachments: A 2-year follow-up of a randomized controlled trial"],"prefix":"10.1007","volume":"29","author":[{"given":"Marwa Abdel","family":"Aal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Kern","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzy","family":"N.Naiem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iman","family":"Abdel wahab Radi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nouran Abdel","family":"Nabi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr Ahmed","family":"Naguib","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Sad","family":"Chaar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"key":"6617_CR1","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/j.1741-2358.2002.00003.x","volume":"19","author":"JS Feine","year":"2002","unstructured":"Feine JS, Carlsson GE, Awad MA et al (2002) The McGill consensus statement on overdentures. 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