• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.4
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• pp.343-358
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• 2011

As implant treatment has become popular, lots of different shapes and materials of the implant upper component have been supplied. And there are also diverse reports about failures including loosening of the abutment screw which is one of the most common reason. Purpose : The purpose of this study is to find out how different screw tightening orders and methods influence on screw loosening according to the different connection systems. The upper component was fabricated by casting method. After fabricating master models that are precisely attached to the upper component, 5 experimental models each for the external connection system and internal connection system were fabricated using splinting impression technique. First, to find out the influence of the screw tightening order, screws were tightened in 3 orders; 1-2-3-4, 2-3-1-4, 2-4-3-1. After tightening, removal torque values (RTV) of each group was measured. And also to find out the influence of screw tightening method, a model with 2-3-1-4 screw tightening order was tightened with 30 Ncm at one time(1-step method) and the RTV was compared with the same order group (2-3-1-4) in the 2 step method. In the external connection system, RTV appeared significantly lower in group 2-3-1-4 than group 2-4-3-1 (p<0.05). And also in the internal connection system, the RTV of group 2-3-1-4 appeared significantly lower than that of group 2-4-3-1 and 1-2-3-4 (p<0.05). When comparing the tightening number of the screw without considering the screw tightening order, the first tightened screw appeared significantly higher RTV than the second one in the external connection system (p<0.05), however there was no significant difference from the first tightened screw to the last tightened screw in the internal connection system. And there was no statistically significant difference between the two screw tightening methods in both internal and external connection system. In the comparison of external and internal connection system, each RTV appeared 16.27 Ncm and 14.25 Ncm and appeared as a statistically significant difference (p<0.05). There was a significant difference in RTV measured according to the screw tightening order. The lowest RTV appeared in the groups started tightening from the middle. There was also a significant difference in RTV between the two connection system groups. A further study is needed to find out the influence factors in RTV and also a study is required related to the load condition.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.4
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• pp.387-392
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• 2016

Purpose: The aim of this study was to investigate the effects of grooved abutments on abutment screw loosening. Materials and methods: This study was conducted to evaluate the abutment screw loosening after 6 months for 50 patients (51 implants) treated at the department of Prosthodontics in Yonsei University Dental Hospital from March, 2015 to July, 2015. A control group with non-grooved abutment consists of 30 implants, and an experimental group with grooved abutment consists of 21 implants. Astra, Straumann, Implantium, Osstem system were used in the study. The abutments with loose screws cases after a period of 6 months has been investigated, with two kinds of measurements: 1) measuring the additional rotational angle on abutment during placement with the same force, 2) measuring the PTV on bucco-cervical area of implant crown. All data collected has been analyzed by normality test followed by Mann-Whitney test using SPSS program. Results: No complications were reported after 6 months for the 51 implants. Abutment screw loose and crown fracture have not been seen in the study groups. The data collected from the two measurements showed no significant differences between the two groups with P-value 0.576 (average= control group: $7.35^{\circ}$, experimental group: $4.75^{\circ}$) for the additional rotational angle measurement and with P-value 0.767 for PTV. Conclusion: There are no significant differences between the grooved and non-grooved abutment in screw stability. However, further studies with long-term followups and larger group of patients is needed in order to investigate the effects of grooved abutment on screw stability.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.2
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• pp.151-155
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• 2017

Purpose: The aim of this study was to evaluate screw removal torque of the two-piece zirconia abutment with the novel titanium component compared to the conventional one-piece titanium abutment in the internal connection implant before and after dynamic cyclic loading. Materials and methods: Two types of the abutment assemblies with internal connection were prepared and divided into the groups; titanium abutment-titanium abutment screw assemblies as control, and zirconia abutment-titanium socket-titanium abutment screw assemblies as experimental group. A total of 12 abutments and implants were used of six assemblies each group. Each assembly was tightened to 30 Ncm. A cyclic load of 300 N at an angle of 30 degrees in reference to the loading axis was applied until one million cycles or failure. The removal torque values (RTVs) of the abutment screws were measured with a digital torque gauge before and after cyclic loading. The RTVs of the pre load and post load were analyzed with t-test, and P-values < .05 were considered statistically significant. Results: The assemblies of both groups survived all after the dynamic cyclic loading test without screw loosening. The statistically significant differences were found between the mean RTVs before and after the cyclic loading in both groups (P < .05). The RTV differences for the control and the experimental group were $-7.25{\pm}1.50Ncm$ and $-7.33{\pm}0.93Ncm$, respectively. Statistical analysis revealed that the RTV differences in both groups were not significantly different from each other (P > .05). Conclusion: Within the limitation of this study, the two-piece zirconia abutment with the titanium component did not show a significant RTV difference of the abutment screw compared to the titanium abutment after dynamic cyclic loading.

• Journal of Ocean Engineering and Technology
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• v.4 no.1
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• pp.25-34
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• 1990

케이싱과 배관 연결(connection)의 구조적이고 기능적인 능력은 가스와 기름을 안전하고 효과적으로 발견하고 개발하는데 매우 중요하다. 이 글에서는 이러한 연결에 관한 일반적이고 기술적인 정보를 소개하였다.

• The Journal of the Korean dental association
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• v.34 no.9 s.328
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• pp.664-665
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• 1996

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.2
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• pp.114-118
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• 2017

Purpose: The aim of this study was to investigate the effects of a titanium component for the zirconia abutment in the internal connection implant system on screw loosening under thermocycling conditions. Materials and Methods: Internal connection titanium abutments and external connection zirconia abutments with titanium sockets were connected respectively to screw-shaped internal connection type titanium implants with 30 Ncm tightening. These implant-screw-abutment assemblies were divided into two groups of five specimens each; titanium abutments as control and zirconia abutments with titanium sockets as experimental group. The specimens were subjected to 2,000 thermocycles in water baths at $5^{\circ}C$ and $55^{\circ}C$, with 60 seconds of immersion at each temperature. The removal torque values (RTVs) of the abutment screws of the specimen were measured before and after thermocycling. RTVs pre- and post-thermocycling were investigated in statistics. Results: There was not screw loosening identified by tactile and visual inspection in any of the specimens during or after thermocycling. The mean RTV difference for the control group and the experimental group were $-1.34{\pm}2.53Ncm$ and $-1.26{\pm}2.06Ncm$, respectively. Statistical analysis using an independent t-test revealed that no significant differences were found in the mean RTV difference of the groups (P > 0.05). Conclusion: Within the limitations of this in vitro study, the titanium socket for the zirconia abutment did not show a significant effect on screw loosening under thermal stress compared to the titanium abutment in the internal connection implant.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.125-135
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• 2009

Statement of problem: Loosening or fracture of the abutment screw is one of the common problems related to the dental implant. Generally, in order to make the screw joint stable, the preload generated by tightening torque needs to be increased within the elastic limit of the screw. However, additional tensile forces can produce the plastic deformation of abutment screw when functional loads are superimposed on preload stresses, and they can elicit loosening or fracture of the abutment screw. Therefore, it is necessary to find the optimum tightening torque that maximizes a fatigue life and simultaneously offer a reasonable degree of protection against loosening. Purpose: The purpose of this study was to present the influence of tightening torque on the implant-abutment screw joint stability with the 3 dimensional finite element analysis. Material and methods: In this study, the finite element model of the implant system with external butt joint connection was designed and verified by comparison with additional theoretical and experimental results. Four different amount of tightening torques(10, 20, 30 and 40 Ncm) and the external loading(250 N, $30^{\circ}$) were applied to the model, and the equivalent stress distributions and the gap distances were calculated according to each tightening torque and the result was analyzed. Results: Within the limitation of this study, the following results were drawn; 1) There was the proportional relation between the tightening torque and the preload. 2) In case of applying only the tightening torque, the maximum stress was found at the screw neck. 3) The maximum stress was also shown at the screw neck under the external loading condition. However in case of applying 10 Ncm tightening torque, it was found at the undersurface of the screw head. 4) The joint opening was observed under the external loading in case of applying 10 Ncm and 20 Ncm of tightening torque. 5) When the tightening torque was applied at 40 Ncm, under the external loading the maximum stress exceeded the allowable stress value of the titanium alloy. Conclusion: Implant abutment screw must have a proper tightening torque that will be able to maintain joint stability of fixture and abutment.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.4
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• pp.321-327
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• 2020

Purpose: The purpose of this study was to measure and compare the strain value exerted on the cervical area using different screw tightening protocols in implant-supported, screw-retained 3-unit prostheses. Materials and methods: Strain gauges were attached to four implants: two external and two internal. Thereafter, two study model were designed each type using acrylic resin. CAD-CAM was used to design hex and nonhex abutments for each group (EH, ENH, IH, and INH group) and Screw-cement-retained prostheses were also designed using a nonprecious base metal. Abutment was fixed with 10 Ncm torque, and the prosthesis was cemented. Screws were fixed with 30 Ncm torque using different three protocols. After 5 min, the strain gauge level was measured, and group analysis was performed (α=.05). Results: External group showed significantly lower strain values than internal group and the EH group showed significantly lower strain values than the ENH group (P<.05). There was no difference in strain value based on the types of screw tightening protocols in same group (P>.05). The IH group exhibited significantly higher strain values than the INH group and the IH group showed a significant difference in strain values based on the types of screw tightening protocols used (P<.05). Conclusion: There was no significant effect on the external type in the implant-supported, screw-retained prostheses. However, strain values were high in the internal type, and the types of screw tightening protocol significantly affected these implants.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.4
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• pp.243-250
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• 2010

Purpose: This study evaluated the effect of different screw tightening sequences and methods on detorque values in a well-fitting implant superstructure. Materials and methods: A fully edentulous mandibular master model and a metal framework directly connected to four parallel implants (Astra Tech) with a passive fit to each other were fabricated. Six stone casts were made with a splinted impression technique to represent a 'well-fitting' situation with the metal framework. Detorque values were measured twice after screw tightening using 20 Ncm. Detorque values and minimum detorque values for three screw tightening sequences (1-2-3-4, 2-4-3-1, and 2-3-1-4) and for two tightening methods (two-step and one-step) were analyzed using multi-way analysis of variance and two-way analysis of variance, respectively, at a .05 level of significance. Results: The mean detorque values for screw tightening sequences ranged from 12.8 Ncm (2-4-3-1) to 13.1 Ncm (2-3-1-4), and for screw tightening methods were 13.1 Ncm (two-step) and 11.8 Ncm (one-step). The mean of mimimum detorque values for screw tightening sequences were 11.1 Ncm (1-2-3-4) and 11.2 Ncm (2-4-3-1 and 2-3-1-4), and for screw tightening methods were 11.2 Ncm (two-step) and 9.9 Ncm (one-step). No statistically significant differences among three screw tightening sequences were found for detorque values and for mimimum detorque values. But, statistically significant differences between two screw tightening methods were found for two values. Two-step screw tightening method showed higher detorque value (P = .0003) and higher minimum detorque value (P = .0035) than one-step method. Conclusion: Within the limitations of this study, the screw tightening sequence was not a critical factor for the detorque values in a well-fitting implant superstructure by the splinted impression technique. But, two-step screw tightening method showed greater detorque values than one-step method.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.2
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• pp.137-147
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• 2008

Statement of problem: Dental implant procedure has been recognized as a very effective treatment to rehabilitate fully or partially edentulous patients. However, mechanical failures such as screw loosening, screw fracture have been still reported frequently. Purpose: The purpose of this study was to evaluate the influence of tungsten carbide/carbon coating, which has superior hardness and frictional wear resistance, on implant-abutment screw loosening of three different joint connections after one million cyclic loading. Material and methods: The values of detorque before and after loading were measured in three different joint connections (Osstem Implant, Korea), one external butt joint, US II implant system and two internal cones, SS II and GS II system. The values of detorque before loading was analyzed by one-way ANOVA, and two-way ANOVA and Scheffe' test were performed for the value of detorque after loading. Results: 1. The values of initial detorque of tungsten carbide/carbon coated Ti alloy screw were smaller those of Ti alloy screw (P<.01), and there were no differences among implant systems in each screw (P>.05). 2. In comparison of loss rate of detorque value after cyclic loading, US II system was greater than SS II and GS II system but there was no difference between SS II and GS II system (P<.01). 3. Loss rates of detorque value after cyclic loading decreased consistently at tungsten carbide/carbon coated Ti alloy screw comparing with Ti alloy screw in all implant systems (P<.01), and there were no differences among three systems in reduction of loss rates by using tungsten carbide/carbon coated Ti alloy screw (P>.05). Conclusion: Tungsten carbide/carbon coating to increase preload with reduction of friction resistance was a effective way to decrease screw loosening by functional loading.