الفهرس 
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Abstract
Aim of the work: This research was carried out to evaluate clinically and radio graphically reliability of either metal or Infibra ribbon bar as an attachment for mandibular complete implant over denture when distally placed solitary implants combined with bar attachment. Materials and method: This study was carried out on six completely edentulous patients, where four implants were installed in the mandible, two were placed the canine area and two were placed in the first molar area. The patients were divided in two equal groups, where the first group patients wore mandibular complete over denture of cast metal bar attachment. The second group patients wore mandibular complete over denture of Infibra ribbon attachment complete over denture. For both groups, distal placed solitary healing implant abutments were used with bar attachment. Permanent silicon soft liner female housing was incorporated in the mandibular complete over denture corresponding to anterior bar splinted implant abutments and posterior solitary implant healing abutment. CBCT radio graphical evaluation for crestal alveolar bone height level, stability of implants, peri-implant gingival probing depth and peri- implant mucosal health was carried out immediately after denture insertion, and after 6, 18 months of denture insertion. Result :1) For both groups, over denture implant abutment of either splinted or non-splinted with bar attachment exhibit an increase in crestal alveolar bone resorption, peri-implant gingival probing depth and implant stability. The peri-implant mucosa was significantly deteriorated clinically.2) There is no significant difference was found when comparing cast metal bar group to Infibra bar group together regards the parameter of evaluation of hard and soft peri-implant tissue health. The reverse result was found when comparing splinted bar implant to solitary implant for each group independently where the tissue health of solitary implants was better than splinted one. Conclusion : 1)Splinted metal bar attachment provided with posterior placed solitary implant was the prosthetic treatment of choice for preventing the peri-implant mucosal health and crestal alveolar bone from resorption. 2)from tissue preservation point of view, Infibra ribbon bar attachment is the alternative treatment option when there is a contra indication for using metal bar attachment for mandibular complete implant over denture.