###### Abstract  
Comprehensive, long-term studies on patient-reported outcomes for two-implant overdentures with magnetic attachments using immediate or conventional loading methods are lacking. This study aimed to provide 5-year follow-up data comparing patient-reported outcomes for mandibular overdentures supported by two implants with magnetic attachments under immediate or conventional loading. Nineteen endentulous mandible patients were randomly assigned to immediate (IG) or conventional loading groups (CG). Two implants were placed with prostheses, loaded on the same day (immediate) or three months later (conventional). Participants completed questionnaires (oral health-related quality of life (OHRQoL), patient general satisfaction, and patient's denture assessment (PDA)) at baseline and yearly intervals for 5 years. Results showed no significant differences between IG and CG throughout the study. However, the within-group analysis revealed significant improvements in OHRQoL, patient satisfaction, and all PDA domains from the baseline to years 1-5. Regarding patient satisfaction, significant differences were observed between T1, T2, and T3 when compared with T0 of IG and T1-T0 of CG. Regarding PDA results of T4-T5, IG exhibited several significant differences compared to CG. In conclusion, this study suggests that two-implant overdentures with magnetic attachments, whether immediately or conventionally loaded, improve patient-reported outcomes. Immediate loading may have prolonged effects on the improvement of patient-reported outcomes. implant; overdenture; magnetic attachment; immediate loading; patient satisfaction; quality of life 20231  
Oral health-related quality of life (OHRQoL) is impacted by tooth loss, with the severity of impairment contingent on the distribution and location of the missing teeth [3]. Tooth loss leading to edentulism can result in orofacial structural changes and functional impairment, reducing chewing efficiency and subsequently increasing the risk of malnutrition [4]. For edentulous patients, oral rehabilitation appears pivotal and significantly improves their quality of life (QoL) [5]. The assessment of OHRQoL and patient satisfaction has historically been conducted using tools like the Oral Health Impact Profile (OHIP) and overall patient satisfaction metrics. Additionally, although OHIP is useful for evaluating OHRQoL, it may prove challenging to gauge improvements in cases where the baseline OHRQoL has not dramatically deteriorated. As a result, an alternative practical approach for assessing dentures has emerged: the patient's denture assessment (PDA) [6]. Owing to advancements in implant surface characteristics and efforts to overcome the physical and psychological challenges of the two-stage surgical protocol [7], immediate and early loading protocols for dental implants have been introduced and refined [8; 9; 10; 11]. The strategy of immediate loading has piqued the interest of researchers and practitioners for decades, enjoying recognized clinical relevance [12]. Contrary to conventional loading, which entails attaching the prosthesis after a 3- to 6-month healing period, the immediate loading technique involves attaching the prosthesis on the same day as implant insertion [13]. As a one-stage surgical intervention, it curtails treatment time and cost, and facilitates clinical monitoring of implant stability during the osseointegration [8]. Concerning clinical outcomes, a literature review suggests there may be no substantial difference between the two loading protocols, immediate and conventional loading, in terms of peri-implant tissue indices and implant stability [14]. By shortening the rehabilitation process and expediting the restoration of oral function, the immediate loading protocol has the potential to enhance patient satisfaction [15] and overall quality of life [16; 17; 18].