{"title":"Mechanical and biological complications of angled versus straight screw channel implant-supported prostheses: A systematic review and meta-analysis.","authors":"Sieu Yien Chiam, Han-Pang Liu, Won-Suk Oh","doi":"10.1016/j.prosdent.2024.10.009","DOIUrl":null,"url":null,"abstract":"<p><strong>Statement of problem: </strong>Scientific evidence to determine the clinical performance of angled screw channel (ASC) versus straight screw channel (SC) implant-supported prostheses is lacking.</p><p><strong>Purpose: </strong>This systematic review and meta-analysis investigated the mechanical and biological complications of ASC compared with those of SC implant-supported prostheses.</p><p><strong>Material and methods: </strong>A systematic search was conducted by following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline in the PubMed, Embase, and Web of Science databases and was supplemented with a manual search for clinical studies reporting the mechanical and biological complications of ASC compared with those of SC implant-supported prostheses. The search was focused on porcelain fracture, screw loosening or fracture, marginal bone loss (MBL), and pink esthetic score (PES). The data were extracted from selected articles and compounded to estimate the complications with a 95% confidence interval (CI) using a random effects meta-analysis. The publication bias was assessed using the Cochrane Risk of Bias and Newcastle-Ottawa Scale (α=.05).</p><p><strong>Results: </strong>A total of 4217 records were identified, and 14 studies were selected for quantitative synthesis of 629 participants with 658 ASC and 166 SC implant-supported prostheses. The meta-analyses of comparative studies showed no statistically significant difference in mechanical complications between ASC and SC prostheses, with odds ratio (OR) of 1.75 (95% CI=0.71-4.34, P=.224). Porcelain fracture and screw loosening were the most common complications with ASC prostheses. In addition, no statistically significant difference was found between ASC and SC prostheses in the MBL (mean difference=-0.07, 95% CI=-0.15-0.01, P=.077) and PES (mean difference=-0.19, 95% CI=-0.90-0.52, P=.593).</p><p><strong>Conclusions: </strong>The clinical performance of ASC may be comparable with that of SC implant-supported prostheses in terms of mechanical and biological complications. However, the moderate level of evidence necessitates further research to validate these findings.</p>","PeriodicalId":16866,"journal":{"name":"Journal of Prosthetic Dentistry","volume":" ","pages":""},"PeriodicalIF":4.3000,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Prosthetic Dentistry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.prosdent.2024.10.009","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Statement of problem: Scientific evidence to determine the clinical performance of angled screw channel (ASC) versus straight screw channel (SC) implant-supported prostheses is lacking.
Purpose: This systematic review and meta-analysis investigated the mechanical and biological complications of ASC compared with those of SC implant-supported prostheses.
Material and methods: A systematic search was conducted by following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline in the PubMed, Embase, and Web of Science databases and was supplemented with a manual search for clinical studies reporting the mechanical and biological complications of ASC compared with those of SC implant-supported prostheses. The search was focused on porcelain fracture, screw loosening or fracture, marginal bone loss (MBL), and pink esthetic score (PES). The data were extracted from selected articles and compounded to estimate the complications with a 95% confidence interval (CI) using a random effects meta-analysis. The publication bias was assessed using the Cochrane Risk of Bias and Newcastle-Ottawa Scale (α=.05).
Results: A total of 4217 records were identified, and 14 studies were selected for quantitative synthesis of 629 participants with 658 ASC and 166 SC implant-supported prostheses. The meta-analyses of comparative studies showed no statistically significant difference in mechanical complications between ASC and SC prostheses, with odds ratio (OR) of 1.75 (95% CI=0.71-4.34, P=.224). Porcelain fracture and screw loosening were the most common complications with ASC prostheses. In addition, no statistically significant difference was found between ASC and SC prostheses in the MBL (mean difference=-0.07, 95% CI=-0.15-0.01, P=.077) and PES (mean difference=-0.19, 95% CI=-0.90-0.52, P=.593).
Conclusions: The clinical performance of ASC may be comparable with that of SC implant-supported prostheses in terms of mechanical and biological complications. However, the moderate level of evidence necessitates further research to validate these findings.
期刊介绍：
The Journal of Prosthetic Dentistry is the leading professional journal devoted exclusively to prosthetic and restorative dentistry. The Journal is the official publication for 24 leading U.S. international prosthodontic organizations. The monthly publication features timely, original peer-reviewed articles on the newest techniques, dental materials, and research findings. The Journal serves prosthodontists and dentists in advanced practice, and features color photos that illustrate many step-by-step procedures. The Journal of Prosthetic Dentistry is included in Index Medicus and CINAHL.
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