PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School (UNICAMP), Piracicaba, São Paulo, Brazil.
Professor, Department of Prosthodontics, Faculty of Technology and Sciences (UniFTC), Salvador, Bahia, Brazil.
J Prosthet Dent. 2024 Aug;132(2):369-380. doi: 10.1016/j.prosdent.2022.06.005. Epub 2022 Jul 19.
Implant-supported single crowns are more prone to screw loosening than splinted prostheses. Therefore, the locking taper system, which has a screwless abutment, may perform better when associated with this type of rehabilitation. However, systematic reviews on this system are lacking.
The purpose of this systematic review was to evaluate the clinical performance and complications of single crowns retained by the locking taper system.
This systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under CRD42020189921. An electronic search was made in 5 databases and 3 other sources up to February 2021 to select prospective clinical studies evaluating the performance of single crowns retained by the locking taper system by using the outcomes implant survival, success rate, complications, marginal bone loss (MBL), and prosthesis success rate. Four meta-analyses grouped according to the follow-up intervals were performed. The risk of bias of the selected studies was evaluated by using the RoB 2 checklist for randomized controlled trials (RCTs) and Downs and Black for uncontrolled studies.
Twelve studies were included: 9 prospective cohort studies and 3 RCTs. A survival rate of 99% (98% to 99%) and a success rate of 97% (92% to 99%) after 5 years were found. Of the total, 2.6% biological and 2.9% prosthetic complications were described. The prosthesis success rate was 97% (96% to 98%) after 5 years. An average of -0.73 mm (-0.93 to -0.52) was found for the MBL after 5 years. The risk-of-bias assessment showed 2 RCTs with high risk and 1 RCT with low risk of bias. Among uncontrolled studies, 2 were classified as poor and 7 as fair.
Single crowns retained by locking taper implants can be safely indicated based on the high survival and success rates achieved in the long term, the maintenance of bone level stability over time, and the low incidence of complications.
与桥体修复体相比，种植体支持的单冠更易发生螺丝松动。因此，当涉及到这种修复类型时，具有无螺丝基台的锁定锥度系统可能表现更好。然而，目前缺乏对此系统的系统评价。
本系统评价的目的是评估使用锁定锥度系统固位的单冠的临床性能和并发症。
本系统评价已在国际前瞻性系统评价注册库（PROSPERO）中注册，注册号为 CRD42020189921。电子检索了 5 个数据库和另外 3 个来源，以选择评估使用锁定锥度系统固位的单冠的性能的前瞻性临床研究，使用的结局包括种植体存活率、成功率、并发症、边缘骨吸收（MBL）和修复体成功率。根据随访时间间隔进行了 4 项荟萃分析。使用随机对照试验（RCT）的 RoB 2 清单和未对照研究的 Downs 和 Black 对所选研究的偏倚风险进行了评估。
纳入了 12 项研究：9 项前瞻性队列研究和 3 项 RCT。5 年后发现，存活率为 99%（98%至 99%），成功率为 97%（92%至 99%）。总共描述了 2.6%的生物学并发症和 2.9%的修复体并发症。5 年后，修复体成功率为 97%（96%至 98%）。5 年后 MBL 的平均值为-0.73mm（-0.93 至-0.52）。偏倚风险评估显示 2 项 RCT 存在高风险，1 项 RCT 存在低风险。在未对照研究中，2 项被评为差，7 项评为一般。
根据长期获得的高存活率和成功率、随时间稳定的骨水平以及低并发症发生率，使用锁定锥度种植体固位的单冠可以安全使用。
