• The Journal of Korean Academy of Prosthodontics
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• v.41 no.4
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• pp.519-531
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• 2003

Statement of problem : Chronic implant screw loosening remains a problem in restorative practices. Some implant manufactureres have introduced abutment screws with treated material, surfaces and macrostructures in an effort to reduce potential loosening. Purpose : This study evaluated the materials and loading cycles on detorque value after dynamic continous fatigue test in the sinulated conditions of posterior single restoration. Material and method : Fourteen of each of the following abutment screws - titanium alloy, gold alloy, gold-tite, and titanium alloy modified - were used in test. SEM is used to verify macrostructures of each screws. $ZrO_2/Al_2O_3$ composite abutment was tightened on $4{\times}10.0mm$ titanium external implant at 30 Ncm. Cyclic loading machine delivered dynamic loading forces between 20 and 320N for 100,000, 200,000, 300,000, 500,000, and 1,000,000 cycles at frequencies 14Hz. Torque and detorque value after loading was measured. Results : All measued screws had different screw length and thread form. Titanium modified screw had greater detorque value than others before and after cyclic loadings(p<0.05). All abutment screws had no significant change in mean percentage of detorque value after loading to initial value after less than 500.000 cyclic loadings, but significant lower value after 1,000,000 cycles(p<0.05). Conclusion : Within limintations of this study all abutment screws may be loosend after about 1 year use. Annual check-up is nessasary to prevent screw loosening.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.1
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• pp.26-31
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• 2017

Purpose: This study was to assess clinically the success rates and technical complications of cement-retained implant-supported single crowns and splinted crowns with zirconia frameworks. Materials and methods: 75 (single crowns: 51, splinted crowns: 24) cement-retained implant-supported single crowns and splinted crowns with zirconia frameworks which were restored in 67 patients were investigated for the evaluation of the success rates and technical complications. All restorations were cemented with temporary cement. Age, gender, restoration position, opposing teeth, restoration type were assessed as possible factors affecting technical complications. Results: During the mean observation period of 22.2 months, cumulative success rates of all restorations were 66.9 (73.2 - 60.6)%. Retention loss was found in 16 restorations (single crowns: 14, splinted crowns: 2), abutment screw loosening and veneer porcelain fracture were found in each 2 single crowns, respectively. According to a Kaplan-Meier survival analysis of single crowns and splinted crowns, the cumulative success rates were 58.9 (66.6 - 51.2)%, 87.5 (96.1 - 78.9)%, respectively. There was a statistically significant difference. The other possible factors did not have a significant effect on the technical complications. Conclusion: Retention loss was the most frequent technical complication. Abutment screw loosening and veneer porcelain fracture were found rarely in single crowns only. Age, gender, restoration position, and antagonist did not have significant effect on the technical complications. Splinted crowns had a higher success rate than single crowns.

• The Journal of Korean Academy of Prosthodontics
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• v.49 no.3
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• pp.197-205
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• 2011

Purpose: This study was to evaluate the accuracy of the implant torque controller used in dental clinics and to investigate whether it was applied appropriately. Materials and methods: Fifty dentists who work in dental clinics were enrolled in this study. Dental (implant) practice career, experience frequency of implant screw loosening and fracture, education of implant torque controller application and infection control methods were included in the survey. 25 Ncm and 30 Ncm of the tightening torque applied to the implant screw were measured by 50 clinicians. After measuring the torque value by using the torque controller, the torque mean according to where education about the implant torque controller was received was analyzed with independent t-test at the significance level of 0.05. Results: The torque controller used in private dental clinics showed 4.78% error ratio. When 50 dentists applied 25 Ncm to the implant screw was $29.0{\pm}8.4$ Ncm, and that in 30 Ncm was $34.3{\pm}9.1$ Ncm. Statistical significance was found between the group that was educated about implant torque application and the group that was not educated. Conclusion: During the prosthodontic treatment with implant, there was difference between actual applied torsion force and the amount torque controller indicated. Clinicians have to not only be well-informed about the accurate usage method of the torque controller, but also keep and manage the torque controller so as to maintain continuous and accurate torque values. Through this, it is considered to achieve clinical results to minimize problems of screw loosening or fracture.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.4
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• pp.432-442
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• 2006

Statement of problem: One of common problems associated with dental implant is the loosening of abutment screws that retain the implants. Purpose : This study was performed to investigate the influence of abutment screw length and repeated tightening on screw loosening in dental implant. Material and method: Forty nine Hexplants (13mm length, 4.3mm diameter, Ti grade IV, Warantec. Co. Ltd. Seongnam, Korea) and cementation type abutments(straight abutment) and abutment screws (0.4mm/pitch) were divided into 7 groups, depending on abutment screw length. Each implant and abutment was tightened to 30Ncm by torque controller(MGT50, MARK-10 Inc., USA) and the removal torque values were measured during 10 consecutive closure/opening trials. Results and Conclusion: The results of comparing the removal torque value are as follows : 1. There is no significant difference in the removal torque value between groups in 10 consecutive closure/opening trials (p = 0.97). 2. If the fractured abutment screw is engaged in longer than 2.425 thread length, there is no significant difference in the preload between the fractured abutment screw and the new abutment screw when both are equally tightened to 30 Ncm. 3. The removal torque value in the 1st trial(24.510 Ncm) was lower than that in the 2nd, 3rd, 4th, 5th, 6th, 7th trials and the removal torque value in the 2nd trials(25.551 Ncm) was maximum and was decreased in 1311owing trials. The removal torque value in the 1st trial was significantly lower than that in the 2nd, 3rd, 4th trials and was significantly higher than that in the 8th, 9th, l0th trials(p<0.05). 4. In the 2nd, 3rd, 4th, 5th, 6th, 7th trials, the abutment screw was mainly influenced by settling effect and the higher preload was obtained In the 8th, 9th, l0th trials, the abutment screw was mainly influenced by adhesive wear and the progressively lower preload was obtained.

• The Journal of Korean Academy of Prosthodontics
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• v.41 no.2
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• pp.128-135
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• 2003

Statement of problem : Implant screw loosening remains a problem in implant prosthodontics. Some abutment screws with treated surfaces were introduced to prevent screw loosening and to increase preload. DLC(Diamond Like Carbon) film has similar properties on hardness, wear resistance, chemical stability, biocompatibility as real diamond materials. Purpose : The purpose of this study was to investigate the effect of lubricant layer on abutment screw and to discriminate more effective method between soft lubricant and hard lubricant to prevent screw loosening. Material and method : In this study, $1{\mu}m$ thickness DLC was used as protective, lubricating layer of titanium screws and 3 times removal torque was measured on the abutment screws to investigate the difference in 10 coated and 10 non-coated abutment screws. Results : The results indicated that the implants with DLC coating group were not more resistant to the applied force in screw loosening. At 32Ncm, the 3 times removal torque in DLC group were $27.75{\pm}2.89,\;25.85{\pm}2.35$ and $26.2{\pm}2.57$. The removal torque in no-coated abutment screws were $27.85{\pm}4.23,\;27.35{\pm}2.81$ and $27.9{\pm}2.31$, respectively. Conclusion : The lubricant layer used in this study was Diamond Like Carbon(DLC) and it have a properties of hard and stable layer. The DLC coating layer was hard enough to prevent distortion of screws in the repeated unscrewing procedure in clinical situation. The reduced friction coefficient in hard DLC layer was not effective to prevent screw loosening.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.2
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• pp.174-184
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• 2006

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.