Abstract

Mechanical torque-limiting devices (TLDs) are widely used in implant dentistry to ensure accurate preload application to prosthetic screws, thereby enhancing the mechanical stability of implant-supported rehabilitations. However, variations in torque delivery remain a clinical concern. This systematic review aimed to evaluate the accuracy of mechanical TLDs by analyzing In vitro studies published between January 2000 and June 2025. Following PRISMA 2020 guidelines, eligible studies were identified across four databases and assessed for methodological quality using a modified Joanna Briggs Institute tool. Results revealed significant discrepancies between the torque values delivered by TLDs and those specified by manufacturers, with spring-type mechanisms demonstrating greater accuracy than beam or friction-based types. Factors such as repeated use, autoclave sterilization, and device brand significantly affected performance, with torque deviations exceeding ±10% in many cases. These findings underscore the importance of routine calibration and highlight the need for clinicians to consider both device type and usage history in clinical protocols. Further research is recommended to assess real-world performance and to support the development of advanced TLDs with integrated calibration features.

Keywords

dental implants, fixed prosthesis, prosthodontics, dental materials