The Journal of Advanced Prosthodontics

The Korean Academy of Prosthodonitics (대한치과보철학회)
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Screw loosening and changes in removal torque relative to abutment screw length in a dental implant with external abutment connection after oblique cyclic loading

  • Lee, Joo-Hee (Department of Prosthodontics, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Cha, Hyun-Suk (Department of Prosthodontics, Asan Medical Center, College of Medicine, University of Ulsan)
  • Received : 2018.03.20
  • Accepted : 2018.12.03
  • Published : 2018.12.31
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Abstract

PURPOSE. This study investigated the effects of abutment screw lengths on screw loosening and removal torque in external connection implants after oblique cyclic loading. MATERIALS AND METHODS. External connection implants were secured with abutment screws to straight abutments. The abutment-implant assemblies were classified into seven groups based on the abutment screw length, with each group consisting of five assemblies. A cyclic load of 300 N was applied at a $30^{\circ}$ angle to the loading axis until one million cycles were achieved. Removal torque values (RTVs) before and after loading, and RTV differences were evaluated. The measured values were analyzed using repeated measures of analysis of variance with the Student-Newman-Keuls multiple comparisons. RESULTS. All assemblies survived the oblique cyclic loading test without screw loosening. There was a significant decrease in the RTVs throughout the observed abutment screw lengths when the abutment-implant assemblies were loaded repeatedly (P<.001). However, the abutment screw length did not show significant difference on the RTVs before and after the experiment when the abutment screw length ranged from 1.4 to 3.8 mm (P=.647). CONCLUSION. Within the limit of this experiment, our results indicate that the abutment screw length did not significantly affect RTV differences after oblique cyclic loading when a minimum length of 1.4 mm (3.5 threads) was engaged. These findings suggest that short abutment screws may yield stable clinical outcomes comparable to long screws in terms of load resistance.

Keywords

References

  1. Gaviria L, Salcido JP, Guda T, Ong JL. Current trends in dental implants. J Korean Assoc Oral Maxillofac Surg 2014;40:50-60. https://doi.org/10.5125/jkaoms.2014.40.2.50
  2. Chee W, Jivraj S. Failures in implant dentistry. Br Dent J 2007;202:123-9. https://doi.org/10.1038/bdj.2007.74
  3. Di Iorio D, Sinjari B, Feragalli B, Murmura G. Biomechanical aspects in late implant failures: scanning electron microscopy analysis of four clinical cases. J Contemp Dent Pract 2011;12:356-60.
  4. Weber HP, Sukotjo C. Does the type of implant prosthesis affect outcomes in the partially edentulous patient? Int J Oral Maxillofac Implants 2007;22:140-72.
  5. Gracis S, Michalakis K, Vigolo P, Vult von Steyern P, Zwahlen M, Sailer I. Internal vs. external connections for abutments/reconstructions: a systematic review. Clin Oral Implants Res 2012;23:202-16. https://doi.org/10.1111/j.1600-0501.2012.02556.x
  6. Sailer I, Muhlemann S, Zwahlen M, Hammerle CH, Schneider D. Cemented and screw-retained implant reconstructions: a systematic review of the survival and complication rates. Clin Oral Implants Res 2012;23:163-201. https://doi.org/10.1111/j.1600-0501.2012.02538.x
  7. Theoharidou A, Petridis HP, Tzannas K, Garefis P. Abutment screw loosening in single-implant restorations: a systematic review. Int J Oral Maxillofac Implants 2008;23:681-90.
  8. Vigolo P, Gracis S, Carboncini F, Mutinelli S; AIOP (Italian Academy of Prosthetic Dentistry) clinical research group. Internal- vs external-connection single implants: A retrospective study in an italian population treated by certified prosthodontists. Int J Oral Maxillofac Implants 2016;31:1385-96. https://doi.org/10.11607/jomi.4618
  9. Katsuta Y, Watanabe F. Abutment screw loosening of endosseous dental implant body/abutment joint by cyclic torsional loading test at the initial stage. Dent Mater J 2015;34:896-902. https://doi.org/10.4012/dmj.2015-023
  10. Sakamoto K, Homma S, Takanashi T, Takemoto S, Furuya Y, Yoshinari M, Yajima Y. Influence of eccentric cyclic loading on implant components: Comparison between external joint system and internal joint system. Dent Mater J 2016;35:929-37. https://doi.org/10.4012/dmj.2016-055
  11. Khraisat A, Hashimoto A, Nomura S, Miyakawa O. Effect of lateral cyclic loading on abutment screw loosening of an external hexagon implant system. J Prosthet Dent 2004;91:326-34. https://doi.org/10.1016/j.prosdent.2004.01.001
  12. Tsuge T, Hagiwara Y. Influence of lateral-oblique cyclic loading on abutment screw loosening of internal and external hexagon implants. Dent Mater J 2009;28:373-81. https://doi.org/10.4012/dmj.28.373
  13. Gupta S, Gupta H, Tandan A. Technical complications of implant-causes and management: A comprehensive review. Natl J Maxillofac Surg 2015;6:3-8. https://doi.org/10.4103/0975-5950.168233
  14. do Nascimento C, Miani PK, Pedrazzi V, Goncalves RB, Ribeiro RF, Faria AC, Macedo AP, de Albuquerque RF Jr. Leakage of saliva through the implant-abutment interface: in vitro evaluation of three different implant connections under unloaded and loaded conditions. Int J Oral Maxillofac Implants 2012;27:551-60.
  15. Taylor TD. Prosthodontic problems and limitations associated with osseointegration. J Prosthet Dent 1998;79:74-8. https://doi.org/10.1016/S0022-3913(98)70197-0
  16. Stuker RA, Teixeira ER, Beck JC, da Costa NP. Preload and torque removal evaluation of three different abutment screws for single standing implant restorations. J Appl Oral Sci 2008;16:55-8. https://doi.org/10.1590/S1678-77572008000100011
  17. Winkler S, Ring K, Ring JD, Boberick KG. Implant screw mechanics and the settling effect: overview. J Oral Implantol 2003;29:242-5. https://doi.org/10.1563/1548-1336(2003)029<0242:ISMATS>2.3.CO;2
  18. Dhingra A, Weiner S, Luke AC, Ricci JL. Analysis of dimensional changes in the screw and the surface topography at the interface of a titanium screw and a zirconia abutment under cyclic loading: an in vitro study. Int J Oral Maxillofac Implants 2013;28:661-9. https://doi.org/10.11607/jomi.2370
  19. Siamos G, Winkler S, Boberick KG. Relationship between implant preload and screw loosening on implant-supported prostheses. J Oral Implantol 2002;28:67-73. https://doi.org/10.1563/1548-1336(2002)028<0067:TRBIPA>2.3.CO;2
  20. Yeo IS, Lee JH, Kang TJ, Kim SK, Heo SJ, Koak JY, Park JM, Lee SY. The effect of abutment screw length on screw loosening in dental implants with external abutment connections after thermocycling. Int J Oral Maxillofac Implants 2014;29:59-62. https://doi.org/10.11607/jomi.3125
  21. Kim BJ, Yeo IS, Lee JH, Kim SK, Heo SJ, Koak JY. The effect of screw length on fracture load and abutment strain in dental implants with external abutment connections. Int J Oral Maxillofac Implants 2012;27:820-3.
  22. ISO 14801. Dentistry - Implants - Dynamic fatigue test for endosseous dental implants. Geneva, Switzerland: International Organization for Standardization 2007.
  23. Khraisat A, Abu-Hammad O, Dar-Odeh N, Al-Kayed AM. Abutment screw loosening and bending resistance of external hexagon implant system after lateral cyclic loading. Clin Implant Dent Relat Res 2004;6:157-64. https://doi.org/10.1111/j.1708-8208.2004.tb00223.x
  24. Pjetursson BE, Thoma D, Jung R, Zwahlen M, Zembic A. A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years. Clin Oral Implants Res 2012;23:22-38.
  25. Bianco G, Di Raimondo R, Luongo G, Paoleschi C, Piccoli P, Piccoli C, Rangert B. Osseointegrated implant for singletooth replacement: a retrospective multicenter study on routine use in private practice. Clin Implant Dent Relat Res 2000;2:152-8. https://doi.org/10.1111/j.1708-8208.2000.tb00006.x
  26. Jemt T, Pettersson P. A 3-year follow-up study on single implant treatment. J Dent 1993;21:203-8. https://doi.org/10.1016/0300-5712(93)90127-C
  27. Att W, Kurun S, Gerds T, Strub JR. Fracture resistance of single-tooth implant-supported all-ceramic restorations: an in vitro study. J Prosthet Dent 2006;95:111-6. https://doi.org/10.1016/j.prosdent.2005.12.003
  28. Mohammed HH, Lee JH, Bae JM, Cho HW. Effect of abutment screw length and cyclic loading on removal torque in external and internal hex implants. J Adv Prosthodont 2016;8:62-9. https://doi.org/10.4047/jap.2016.8.1.62
  29. Craig RG. Restorative dental materials. 9th ed, Mosby, St. Louis; 1993. p. 75-7.
  30. Dittmer MP, Dittmer S, Borchers L, Kohorst P, Stiesch M. Influence of the interface design on the yield force of the implant-abutment complex before and after cyclic mechanical loading. J Prosthodont Res 2012;56:19-24. https://doi.org/10.1016/j.jpor.2011.02.002
  31. Mericske-Stern R, Zarb GA. In vivo measurements of some functional aspects with mandibular fixed prostheses supported by implants. Clin Oral Implants Res 1996;7:153-61. https://doi.org/10.1034/j.1600-0501.1996.070209.x
  32. Alkan I, Sertgoz A, Ekici B. Influence of occlusal forces on stress distribution in preloaded dental implant screws. J Prosthet Dent 2004;91:319-25. https://doi.org/10.1016/j.prosdent.2004.01.016
  33. Choi JH, Yang JH, Cho WP, Lee JB. The influence of abutment screw length and repeated tightening on screw loosening in dental implant. J Korean Acad Prosthodont 2006;44:432-42.
  34. Sopwith DG. The distribution of load in screw threads. Proc Inst Mech Eng 1948;159:373-83. https://doi.org/10.1243/PIME_PROC_1948_159_030_02
  35. Jemt T. Failures and complications in 391 consecutively inserted fixed prostheses supported by Branemark implants in edentulous jaws: a study of treatment from the time of prosthesis placement to the first annual checkup. Int J Oral Maxillofac Implants 1991;6:270-6.
  36. Jemt T, Linden B, Lekholm U. Failures and complications in 127 consecutively placed fixed partial prostheses supported by Branemark implants: from prosthetic treatment to first annual checkup. Int J Oral Maxillofac Implants 1992;7:40-4.
  37. Luterbacher S, Fourmousis I, Lang NP, Bragger U. Fractured prosthetic abutments in osseointegrated implants: a technical complication to cope with. Clin Oral Implants Res 2000;11:163-70 https://doi.org/10.1034/j.1600-0501.2000.110209.x
  38. Yi Y, Koak JY, Kim SK, Lee SJ, Heo SJ. Comparison of implant component fractures in external and internal type: A 12-year retrospective study. J Adv Prosthodont 2018;10:155-62. https://doi.org/10.4047/jap.2018.10.2.155
  39. Binon PP. The effect of implant/abutment hexagonal misfit on screw joint stability. Int J Prosthodont 1996;9:149-60.
  40. McGlumphy EA, Mendel DA, Holloway JA. Implant screw mechanics. Dent Clin North Am 1998;42:71-89.
  41. Dixon DL, Breeding LC, Sadler JP, McKay ML. Comparison of screw loosening, rotation, and deflection among three implant designs. J Prosthet Dent 1995;74:270-8. https://doi.org/10.1016/S0022-3913(05)80134-9
  42. Coppede AR, Faria AC, de Mattos Mda G, Rodrigues RC, Shibli JA, Ribeiro RF. Mechanical comparison of experimental conical-head abutment screws with conventional flat-head abutment screws for external-hex and internal tri-channel implant connections: an in vitro evaluation of loosening torque. Int J Oral Maxillofac Implants 2013;28:e321-9. https://doi.org/10.11607/jomi.3029
  43. Shin HM, Huh JB, Yun MJ, Jeon YC, Chang BM, Jeong CM. Influence of the implant-abutment connection design and diameter on the screw joint stability. J Adv Prosthodont 2014;6:126-32. https://doi.org/10.4047/jap.2014.6.2.126
  44. Feitosa PC, de Lima AP, Silva-Concilio LR, Brandt WC, Neves AC. Stability of external and internal implant connections after a fatigue test. Eur J Dent 2013;7:267-71. https://doi.org/10.4103/1305-7456.115407
  45. Assuncao WG, Delben JA, Tabata LF, Barao VA, Gomes EA, Garcia IR Jr. Preload evaluation of different screws in external hexagon joint. Implant Dent 2012;21:46-50. https://doi.org/10.1097/ID.0b013e31823fcbce
  46. Maeda Y, Satoh T, Sogo M. In vitro differences of stress concentrations for internal and external hex implant-abutment connections: a short communication. J Oral Rehabil 2006;33:75-8. https://doi.org/10.1111/j.1365-2842.2006.01545.x
  47. Stockton LW. Factors affecting retention of post systems: a literature review. J Prosthet Dent 1999;81:380-5. https://doi.org/10.1016/S0022-3913(99)80002-X

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