Accuracy of mechanical torque-limiting devices for implant screw tightening: A systematic review and meta-analysis

Ying S Wang; Chun-Teh Lee; Eswar Kandaswamy; Kalia Theodorou; Hua-Hong Chien

doi:10.1016/j.prosdent.2022.08.013

Accuracy of mechanical torque-limiting devices for implant screw tightening: A systematic review and meta-analysis

J Prosthet Dent. 2022 Sep 20:S0022-3913(22)00509-1. doi: 10.1016/j.prosdent.2022.08.013. Online ahead of print.

Authors

Ying S Wang¹, Chun-Teh Lee², Eswar Kandaswamy³, Kalia Theodorou⁴, Hua-Hong Chien⁵

Affiliations

¹ Clinical Assistant Professor, Department of Periodontics, School of Dentistry, Texas A&M University, Dallas, Texas.
² Associate Professor, Department of Periodontics and Dental Hygiene, University of Texas Health Science Center at Houston, Houston, Texas.
³ Assistant Professor, Department of Periodontics, Louisiana State University School of Dentistry, New Orleans, La.
⁴ Graduate student, Graduate Periodontics, Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio.
⁵ Clinical Professor, Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio. Electronic address: chien.60@osu.edu.

PMID: 36150929
DOI: 10.1016/j.prosdent.2022.08.013

Abstract

Statement of problem: A consensus is lacking on the accuracy of torque value on different types of mechanical torque-limiting devices.

Purpose: The purpose of this systematic review and meta-analysis was to determine the accuracy of unused mechanical torque-limiting devices.

Material and methods: Electronic searches were conducted until October 2021 in 6 electronic databases. Relevant articles were manually screened in 5 journals from January 2000 to October 2021. Two reviewers screened titles, abstracts, and full texts and extracted the data independently. A meta-analysis was conducted to evaluate the weighted mean difference in torque value deviation from target torque between spring-style and friction-style devices as a primary outcome. Deviations of output torque value from target value in spring-style or friction-style devices were also analyzed as a secondary outcome.

Results: A total of 11 595 articles were identified, and 16 articles were included for final statistical analysis. Meta-analysis of the included articles showed that torque value deviation in the spring-style was significantly lower than in the friction-style devices (-0.99 Ncm, 95% confidence interval [CI]: [-1.89, -0.09], P=.030). Deviations of output torque value from target value was -0.54 Ncm in the spring-style group (CI: [-1.23, 0.15], P=.122) and -0.18 Ncm in the friction-style group (95% CI: [-1.40, 1.04], P=.770). Meta-regression analysis indicated that target value was significantly associated with the mean deviation from target value only in the spring-style group. High heterogeneity was found, suggesting more studies with standardized research design are required.

Conclusions: Both spring- and friction-style mechanical torque-limiting devices can produce relatively accurate torque values; however, unused spring-type devices tend to have lower deviation from target torque value than unused friction-type devices.

Publication types

Review