THE INFLUENCE OF IMPLANT FIXTURE-ABUTMENT CONNECTION DESIGN ON SCREW LOOSENING

임플랜트 지대주에 따른 나사 풀림의 연구

  • Mun Yang-Suk (Department of Prosthodontics, Graduate School, Chonnam National University) ;
  • Park Sang-Won (Department of Prosthodontics, Graduate School, Chonnam National University) ;
  • Vang Mong-Sook (Department of Prosthodontics, Graduate School, Chonnam National University) ;
  • Yang Hong-So (Department of Prosthodontics, Graduate School, Chonnam National University) ;
  • Park Ha-Ok (Department of Prosthodontics, Graduate School, Chonnam National University)
  • 문양숙 (전남대학교 치의학 전문대학원 보철학교실) ;
  • 박상원 (전남대학교 치의학 전문대학원 보철학교실) ;
  • 방몽숙 (전남대학교 치의학 전문대학원 보철학교실) ;
  • 양홍서 (전남대학교 치의학 전문대학원 보철학교실) ;
  • 박하옥 (전남대학교 치의학 전문대학원 보철학교실)
  • Published : 2006.04.01

Abstract

Purpose: Current trend in implant dentistry is changing from external connection to internal connection. To evaluate the splinting of external and internal connection implant on screw loosening, 2-units prosthesis was fabricated with BioPlant $System^(R)$ of external connection type and Lifecore STAGE-1 Single Stage Implant $System^(R)$ of internal connection type. Material and Method: Experimental group is classified into three groups. 1) $G_1-EE$: 2-units prosthesis was fabricated with two Bioplant $System^(R)$ of external connection type. 2) $G_1-EI$: 2-units prosthesis was fabricated with one BioPlant $System^(R)$ of external connection type and one Lifecore STAGE-1 Single Stage Implant $System^(R)$ of internal connection type. 3) $G_1-II$: 2-units prosthesis was fabricated with two Lifecore STAGE-1 Single Stage Implant $System^(R)$ of internal connection type. In fabricating 2-units prosthesis, two hexed abutments are recommended when two implants are installed parallel, otherwise one hexed abutment is used on major occlusal force area and one nonhexed abutment is used on the other area. Since it is rare to find two implants being parallel, it is hard to fabricate prosthesis with passive adaptation using two hexed abutments. It is much more difficult to acquire passive adaptation when using hex abutment compared to nonhex abutment. To evaluate the influence of hexed and nonhexed abutment on screw loosening, 2-units prosthesis was fabricated with hexed and nonhexed abutment. Experimental group is classified into three groups. 1) $G_2-HH$: 2-units prosthesis was fabricated with two hexed abutments. 2) $G_2-HN$: 2-units prosthesis was fabricated with one hexed abutment and one nonhexed abutment. 3) $G_2-NN$: 2-units prosthesis was fabricated with two nonhexed abutments. Result: The results of comparing the detorque value after loading on a each prosthesis periodically are as follows. 1. In splinting group of external and internal connection implant, $G_1-II$ group demonstrated the biggest detorque value, followed by $G_1-EI$ group and $G_1-EE$ group. 2. There is no notable significance between external connection implant of $G_1-EI$ group and $G_1-EE$ group and also no significance between internal connection implant of $G_1-EI$ group and $G_1-II$ group. 3. $G_2-HH$ group showed higher detorque value than $G_2-HN\;and\;G_2-NN$ group. From the results, we can concluded that using both external connection and internal connection implant together is clinically acceptable and in order to acquire a good passive adaptation in fabricating 2-units implant prosthesis we can use two nonhexed abutments.

Keywords

References

  1. Branemark PI. Osseointegration and its experimental background. J Prosthet Dent 1983:50:399-410 https://doi.org/10.1016/S0022-3913(83)80101-2
  2. Lee CW. The Comparison of Internalvs-External Implant/Abutment connection. Dental Implants JungWonSa 2002:66-77
  3. Goodacre CJ, Kan JY, Rungcharassaeng K. Clinical complications of osseointegrated implants. J Prosthet Dent 1999 May:81 (5): 537-52 https://doi.org/10.1016/S0022-3913(99)70208-8
  4. Tolman DE, Laney WR. Tissue-integrated prosthesis complications. Int J Oral Maxillofac Implants 1992 Winter:7(4): 477-84
  5. Carlson B, Carlsson GE. Prosthodontic complications in osseointegrated dental implant treatment. Int J Oral Maxillofac Implants 1994 Jan-Feb:9(1) :90-4
  6. Taylor TD. Prosthodontic problems and limitations associated with osseointegration. J Prosthet Dent 1998 Jan:79(1) :74-8 https://doi.org/10.1016/S0022-3913(98)70197-0
  7. Binon PP. The external hexagonal interface and screw-joint stability: A primer on threaded fasteners in implant dentistry. QDT 2000:23:91-104
  8. McGlumphy EA Mendel DA Holloway JA Implant screw mechanics. Dent Clin North Am 1998 Jan:42(1):71-89
  9. Binon PP, Sutter F, Beaty K. Brunski J, Gulbransen H, Weiner R. The role of screws in implant systems. Int J Oral Maxillofac Implants 1994; 9: 48-63
  10. Martin WC, Woody RD, Miller BH, Miller AW. Implant abutment screw rotations and preloads for four different screw materials and surfaces. J Prosthet Dent 2001 Jul: 86(1) :24-32 https://doi.org/10.1067/mpr.2001.116230
  11. Lang LA May KB, Wang RF. The effect of the use of a counter torque device on the abutment-implant complex. J Prosthet Dent 1999 Apr:81(4) :411-7 https://doi.org/10.1016/S0022-3913(99)80007-9
  12. Korioth TW, Cardoso AC, Versluis A. Effect of washers on reverse torque displacement of dental implant gold retaining screws. J Prosthet Dent 1999 Sep: 82(3):312-6 https://doi.org/10.1016/S0022-3913(99)70086-7
  13. Bickford JH. An introduction to the design and behavior of bolted joints. New York: Marcel Dekker: 1981. p.247-64.9
  14. Cibirka RM, Nelson SK. Lang BR, Rueggeberg FA. Examination of the implant-abutment interface after fatigue testing. J Prosthet Dent 2001 Mar:85(3): 268-75 https://doi.org/10.1067/mpr.2001.114266
  15. Haack JE. Sakaguchi RL, Sun T, Coffey JP. Elongation and preload stress in dental implant abutment screws. Int J Oral Maxillofacial Implants 1995: 10: 529-36
  16. Gratton DG, Aquilino SA Stanford CM. Micromotion and dynamic fatigue properties of the dental implant-abutment interface. J Prosthet Dent 2001 Jan:85(1) :47-52 https://doi.org/10.1067/mpr.2001.112796
  17. Sakaggchi RL, Borgersen SE. Nonlinear contact analysis of preload in dental implant screw. Int J Oral Maxillofacia Implants 10: 295-302, 1995
  18. Lee DH et al. Osseointegrated Implant. Shinhung International p479
  19. Jorneus L, Jemt T, Carlsson L. Loads and design of screw for single crowns supported by osseointegrated implants. Int J Oral Maxillofac Implants 1992:353-359
  20. Haak JE, Sakaguchi RL, Sun T, Coffey JP. Elongation and preload stress in dental implant abutment screws. Int J Oral Maxillofac Implants 1995: 10: 529-536
  21. Binon P Weir D. Watanabe L, Walker L. Implant component compatibility. In Laney WR, Tolman, TE (eds) (Proceeding of the 2nd international congress on tissue integration in oral,orthopedic and maxillofacial reconstruction23-27 Sep .1990, Mayo medial center, Rochester. Minnesota.l Chicago, Quitessence, 1992
  22. Carr AB, Brunski JB, Hurley E. The effect of finishing and polishing techniques on implant cylinder preload
  23. Norton MR, An in vitro evaluation of the strength of an internal conical interface compared to a butt joint interface in implant design. Clin Oral Implants Res 1997 Aug;8(4) :290-8 https://doi.org/10.1034/j.1600-0501.1997.080407.x
  24. Merz BR. Mechanics of the ImplantAbutment Connection:An 8 Degree Taper Compared to a Butt Joint Connection. Int J Oral Maxillofac Implants 2000; 15 :519-526
  25. Sutter F, Weber HP, Sorensen J, Belser U. The new restorative concept of the ITI dental implant system: design and engineering. Int J Periodont Rest Dent 1993; 13: 409-31
  26. Binon PP. Implants and components: entering the new millennium. Int J Oral Maxillofac Implants 2000 Jan-Feb;15(1): 76-94
  27. Carlsson GE, Haraldson T. Funtional response in tissue integrated prosthesis, 4th edition. Quintenssence Publ, co. 1986:74-78
  28. Richter EJ. Related Articles, In vivo vertical forces on implants. Int J Oral Maxillofac Implants. 1995 Jan-Feb; 10(1): 99-108
  29. Bates JF, Stafford GD, Harrison A. Masticatory funtion-a review of the literature. III. Masticatory perfomance and efficiency. J Oral Rehabilitation 1976:3:57-62 https://doi.org/10.1111/j.1365-2842.1976.tb00929.x
  30. Graf H. Dent Clin North Am 13:659-665, 1969
  31. Goheen KL. Vermilyea SG, Vassoughi J. Agar JR, Torque generated by hand held screw drivers and mechanical torquing devices for osseointegrated implants. Int J Oral maxillofac Implants 1994: 149-155
  32. Lee CW. Monthly publication. Dental Clinic. Abutment selection guide. 2001:21(3)
  33. Jung WH, Kay KS. A study on the use of sealer on implnat abutment loosening. 1996
  34. Lee JH. Kay KS. An experimental study on single-tooth implant abutment screw loosening to the pitch of thread. 1996
  35. Kim JM, Han JS. A Study Of Screw Loosening After Dynamic Continuous Fatigue Test Of Several Abutment Screw. The Korean Academy of Prosthodontics 2003 41(4) : 519-531
  36. Yang JS. Vang MS. A vitro study of retained screw stability by various connection designs between fixture and abutment in implant dentistry. 2003
  37. English CE. Implant-supported versus implant-natural tooth supported fixed partial denture. Dental Symposia 1993: 1: 10-15