## 4 Discussion
\begin{table}
\begin{tabular}{c c c c c c} \hline \hline  & & **T1-T0** & **T2-T0** & **T3-T0** & **T4-T0** & **T5-T0** \\ \hline \multirow{3}{*}{Function} & IG & 0.037 * & 0.058 & 0.036 * & 0.208 & 0.017 * \\  & CG & 0.025 * & 0.017 * & 0.028 * & 0.028 * & 0.028 * \\ \multirow{3}{*}{Mandibular} & IG & 0.017 * & 0.022 * & 0.012 * & 0.069 & 0.025 * \\  & CG & 0.012 * & 0.017 * & 0.028 * & 0.063 & 0.091 \\ \multirow{3}{*}{Maxillary} & IG & 0.013 * & 0.013 * & 0.012 * & 0.050 * & 0.017 * \\  & CG & 0.012 * & 0.012 * & 0.028 * & 0.063 & 0.063 \\ \multirow{3}{*}{Expectation} & IG & 0.013 * & 0.007 * & 0.012 * & 0.050 * & 0.017 * \\  & CG & 0.012 * & 0.012 * & 0.028 * & 0.091 & 0.128 \\ \multirow{3}{*}{Estehetic and} & IG & 0.013 * & 0.007 * & 0.012 * & 0.050 * & 0.017 * \\  & CG & 0.012 * & 0.017 * & 0.028 * & 0.091 & 0.091 \\ \multirow{3}{*}{Dipordance} & IG & 0.022 * & 0.037 * & 0.012 * & 0.093 & 0.025 * \\  & CG & 0.025 * & 0.012 * & 0.028 * & 0.091 & 0.091 \\ \hline \hline \end{tabular}  
* there is a significant difference in scores between each stage and T0.  
\end{table} 
Table 8: \(p\)-value of median differences in six domains of PDA scores between baseline and each yearly evaluation period within each group (immediate loading group (IG); conventional loading group (CG)). by [PERSON] et al. similarly reported the long-term effects of the immediate loading protocol on improving several subscales of PDA scores [19]. Additionally, regarding patient satisfaction, significant differences were observed between T1, T2, and T3 when compared with T0 for the immediate group, while in the conventional group, the only significant difference was between T1-T0. This implies that immediate loading may have enduring positive effects on patient-reported outcomes. The utilization of magnetic attachments as an attachment solution appears effective in mitigating stress within the peri-implant bone during an overdenture dislodgment [31]. Also, when the prosthesis is absent in the oral cavity, magnets are less conspicuous, smoother, and more comfortable. Patient preference for the magnet system is driven by considerations such as ease of cleaning, comfort, and the ability to speak and eat [32]. Previous studies using different types of attachments also reported no significant difference between immediate and conventional loading groups concerning patient-reported outcomes. For instance, [PERSON] et al. analyzed the impact of QoL on implant overdententents using ball attachments and found no significant difference between the two groups when comparing answers to the pre-and post-treatment questionnaires [33]. Similarly, utilizing bar attachments, [PERSON] reported that no differences were noted in any outcomes between the two groups [34]. Thus, mandibular two-implant overdentures with immediate loading using the magnetic attachment could be regarded as a successful treatment approach from a patient's standpoint. The results of this study have to be interpreted in light of some limitations. Although the sample size aligns with earlier studies of similar objectives and techniques [19; 21], a small sample size can lead to reduced statistical power. In this case, the statistical power was 69.4%, given that mean patient satisfaction scores were 89.9 and 80.5 for the immediate and conventional groups, respectively, at the 5-year follow-up, with standard deviations of 3.78 and 8.57. This potentially contributed to the lack of significance in changes between the two groups regarding patient satisfaction, OHIP summary, and domain scores, particularly for the 5-year follow-up. In addition, despite using the minimization method to ensure comparability of the groups pre-treatment, the differences in age, gender, and American College of Prosthodontists (ACP) classification might impact the study's outcomes. To comprehensively understand the long-term impact of immediate-loaded mandibular implant-supported overdentures on patient-reported outcomes, a randomized controlled trial with a larger size and more uniform maxillary denture condition is required.