De Angelis Paolo, Rella Edoardo, Liguori Margherita Giorgia, Piccirillo Davide, Palmieri Alberto, D'addona Antonio, Manicone Paolo Francesco
Division of Oral Surgery and Implantology, Department of Head and Neck, Institute of Clinical Dentistry, Oral Surgery and Implantology Unit, A. Gemelli University Hospital Foundation (IRCCS) Catholic University of the Sacred Heart, Rome, Italy.
Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
J Prosthodont. 2025 Mar;34(3):240-251. doi: 10.1111/jopr.14032. Epub 2025 Jan 27.
Screw-retained implant crowns are a common solution to rehabilitate single or multiple edentulous sites. Angulated screw channel (ASC) abutments have been developed as a new system of connection to correct the angulation of the implant and avoid a possible undesired emergence of the access hole. The purpose of this systematic review was to examine available literature related to the effects of ASC abutments in rehabilitating single implant crowns.
A protocol was registered in the PROSPERO database (ID = CRD42022295521). An electronic search of the Cochrane Central Register of Controlled Trials and Trial Protocols, MEDLINE, SCOPUS, and Web of Science was performed up to January 16, 2024. Additionally, a manual search was carried out. The meta-analysis used a fixed or a random effects model, based on the heterogeneity between the studies, focusing on binary and continuous data. A risk of bias assessment was performed (NOS or MOGA et al.) The outcomes assessed were peri-implant marginal bone level, probing pocket depth (PPD), the prevalence of technical and mechanical complications, implant and prosthesis survival rates, and esthetics. Statistical significance was set at p < 0.05.
The searches resulted in a total of 10 studies included in the meta-analysis. The mean implant and prosthesis survival rates were respectively 99% (absolute quantity = 243) and 100% (absolute quantity = 239) with non-statistically significant differences observed in single crowns supported by ASC abutments compared to cemented restorations, in terms of marginal bone loss (MBL) (p = 0.22), PPD (p = 0.08), risk of complications (p = 0.53), and esthetics (p = 0.47). Follow-up intervals ranged from 14 days to more than 3 years.
Data based on this systematic review suggest that the clinical and radiographic outcomes of single implants restored using ASC are promising if compared to the outcomes relating to screw-retained single crowns.
螺丝固位种植体冠是修复单个或多个无牙区的常用解决方案。角度螺丝通道（ASC）基台已作为一种新的连接系统被开发出来，用于纠正种植体的角度并避免接入孔出现可能的不良情况。本系统评价的目的是研究与ASC基台在修复单个种植体冠方面的效果相关的现有文献。
在PROSPERO数据库（ID = CRD42022295521）中注册了一项方案。截至2024年1月16日，对Cochrane对照试验中央注册库、试验方案、MEDLINE、SCOPUS和科学网进行了电子检索。此外，还进行了手工检索。荟萃分析根据研究间的异质性使用固定效应或随机效应模型，重点关注二元数据和连续数据。进行了偏倚风险评估（NOS或MOGA等人）。评估的结果包括种植体周围边缘骨水平、探诊袋深度（PPD）、技术和机械并发症的发生率、种植体和修复体生存率以及美观情况。统计学显著性设定为p < 0.05。
检索结果共有10项研究纳入荟萃分析。在由ASC基台支持的单冠与粘结修复体相比时，种植体和修复体的平均生存率分别为99%（绝对数量 = 243）和100%（绝对数量 = 239），在边缘骨丢失（MBL）（p = 0.22）、PPD（p = 0.08）、并发症风险（p = 0.53）和美观情况（p = 0.47）方面未观察到统计学显著差异。随访间隔从14天到3年以上不等。
基于本系统评价的数据表明，与螺丝固位单冠的结果相比，使用ASC修复单个种植体的临床和影像学结果很有前景。
