Journal of Prosthodontics News
Straight Versus Angled Screw Channel Considerations in Anterior Maxilla using CBCT
Now online in the Journal of Prosthodontics, a study on the angular deviations necessary to obtain screw-retained restorations for immediately placed implant restorations, co-authored by ACP members, Alexander Bendayan, DDS, CAGS, MBA, Jack Piermatti, DMD, FACP, and Daniel B. Feit, DMD, CAGS.
This study was designed to add to information from previously published studies on the frequency of different angulation corrections in order to obtain a screw-retained restoration.
Anterior maxillary CBCT scans of patients were reviewed for maxillary central incisors, lateral incisors, and canines. The scans were imported to implant planning software. Mid sagittal sections were identified, implants were virtually placed using established clinical criterion, and virtual straight abutments were planned on those sites. The emergence of the abutment access channels was checked, and angular corrections were incrementally made from 5 to 25 degrees till the access channels were lingual to the incisal edges. The prevalence of each angulation and degrees of angulation were then compared among the tooth types by using Fishers’ Exact test.
A total of 295 sites in the anterior maxilla were evaluated. The results demonstrated that the greatest percentage of straight access channels was found at canine sites (51%) and the least at lateral incisors (5.1%). There was a significant increase in access channel through the cingulum using angled screw channel systems (p < 0.01) for each tooth type. The lateral incisor required the most significant angle correction among the anterior teeth.
The decision to plan a screw-retained versus cemented restoration in the anterior maxilla is pivotal for a successful clinical outcome and establishing the prosthetic workflow. Angled screw channel systems can potentially aid in planning immediate implants in the anterior maxilla in the correct 3D position in bone and still achieve a screw-retained restoration with more predictable biologic and prosthetic outcomes.
Khan MT, Bendayan A, Piermatti J, Feit DB, Joshi N. Straight versus angled screw channel considerations in anterior maxilla using CBCT for planning immediate implant placement: A radiographic study. J Prosthodont. 2026; 1–7. https://doi.org/10.1111/jopr.70110
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