• The Journal of Korean Academy of Prosthodontics
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• v.45 no.5
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• pp.653-664
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• 2007

Statement of problem: The screw detorque value is a measure of the preload remaining in the screw just before detorquing. Purpose: This study evaluated the effect of different screw tightening sequences and tightening methods on detorque values for a well-fitting implant superstructure. Material and method: An implant superstructure that connected directly to four implants (Astra Tech) was fabricated on a fully edentulous mandibular acrylic resin model. Six well-fitting dental stone casts were made with a pickup impression of the superstructure from the acrylic resin model. To evaluate the effect of three screw tightening sequences (1-2-3-4, 2-4-3-1, and 2-3-1-4) and two tightening methods (2-step and 1-step) on the stability of screw joint, the detorque values for a well-fitting implant superstructure were measured twice after screw tightening using 20 Ncm. Detorque values were analyzed using multi-way analysis of variance and two-way analysis of variance at a .05 level of significance. Results: 1. The mean detorque values for three screw tightening sequences were 12.3 Ncm, 12.6 Ncm, and 12.0 Ncm, respectively. 2. The mean detorque values for two screw tightening methods were 12.0 Ncm, and 12.2 Ncm, respectively. 3. The mean of mimimum detorque values for three screw tightening sequences and for two tightening methods were 10.6 Ncm, 11.1 Ncm, 10.5 Ncm, and 9.8 Ncm, respectively. 4. No statistically significant differences among the variables of screw tightening sequence and tightening method were found (p>.05) for detorque values and for mimimum detorque values. Conclusion: Within the limitations of this study, the screw tightening sequence and tightening method did not have a significant effect on the detorque values for a well-fitting implant superstructure.

• The Journal of the Korean dental association
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• v.53 no.11
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• pp.804-816
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• 2015

PURPOSE: The aim of this study was to evaluate the influence of the oxide layer removal process in the Co-Cr-Mo (CCM) abutment after casting procedure on the prosthesis settlement and screw stability. MATERIALS AND METHODS: CCM abutments of four different interface conditions (CCM-M; machined, CCM-O; oxide layer formed, CCM-B; blasted, CCM-P; polished after blasted) and gold abutment (Gold-C; Cast with type III Gold alloy) were used. The initial settling values of abutments were evaluated according to the difference of implant-abutment length when the tightening torques were applied at 5 Ncm and 30 Ncm, and the settling values of abutments caused by loading were evaluated according to the difference of implant-abutment length before and after loading with 250 N, 100000 cycle. The loss ratios of removal torque for abutment screws were evaluated according to the difference in value of removal torques under 30 Ncm tightening torque applied before and after cyclic loading. RESULTS: The CCM-P and CCM-B group showed a higher initial settling value compared with the Gold-C group (P<.05), while the Gold-C group showed the highest settling values caused by loading (P<.05) and no significant differences were observed for between CCM groups (P>.05). The loss ratio of removal torque values for the CCM-B, CCM-P groups did not differ significantly from that of the Gold-C group (P>.05). CONCLUSION: Even though the oxide layer was removed by different methods, CCM abutment with internal conical connection structure showed lower abutment settling and similar screw loosening after cyclic loading compared with gold abutment.

• 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.50 no.2
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• pp.92-98
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• 2012

Purpose: The aim of this study was to evaluate the effects of different abutment materials on abutment screw loosening and settling-down effect in conical connection type implant system. Materials and methods: Three types of abutment, cementation, gold UCLA, and metal UCLA abutment were used. Two UCLA groups were fabricated in a similar pattern to cementation abutment. Type III gold alloy and Nickel-Chromium alloy was used for casting gold UCLA abutment and metal UCLA abutment, respectively. Fixture and abutment were tightened to 30 Ncm by using digital torque controller and re-tightening was conducted with same force after 10 minutes. Digital torque gauge was used to measure loosening torque and fixture/abutment length was measured by digital micrometer. Dynamic loads between 25 N and 250 N were applied with $0^{\circ}$ angle to the abutment axis. After loading, fixture/abutment length was re-measured and amount of settlement was calculated. Loosening torque value was also measured for comparison Results: All three groups showed significant differences of length when comparing before and after loading, but there was no significant difference of settling amount in all groups. Loosening torque values were significantly decreased when comparing before and after loading in all groups($P$<.05). However, there was no significant difference in loss of loosening torque values when compared to groups. Conclusion: In internal conical connection type implants, dynamic load affected on settlement and loosening torque of implant, but there was no differences between abutments materials. Likewise gold UCLA abutment, metal UCLA abutment might be able to withstand functional load.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.2
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• pp.93-102
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• 2016

Purpose: The aim of this study was to evaluate the fit accuracy of two zirconia and titanium abutments in internal hexagonal implants. Materials and methods: One titanium abutment and two zirconia abutments were tested in internal hexagonal implants (TSV, Zimmer). Prefabricated zirconia abutments (ZirAce, Acucera) and customized zirconia abutments milled by the Zirkonzahn system (Zirkonzahn Max, Zirkonzahn) were selected and prefabricated titanium abutments (Hex-Lock, Zimmer) were used as a control. Eight abutments per group were connected to implants with 30 Ncm torque. The marginal gaps at abutment-implant interface, the internal gaps at internal hex, vertical and horizontal gaps between screws and screw seats in abutments were measured after sectioning the embedded specimens using a scanning electron microscope. Data analysis included one-way analysis of variance and the Scheffe test (n=16, ${\alpha}=0.05$). Results: The mean marginal gap of customized zirconia abutment was higher than those of two prefabricated zirconia and titanium abutments. The internal gaps at internal hex showed no significant differences between customized and prefabricated abutments and were higher than those of prefabricated titanium abutments. The mean vertical and horizontal gaps at screw in prefabricated zirconia abutment were higher than those of prefabricated titanium abutment. In the case of customized zirconia abutment, the mean horizontal gap at screw was higher than those of both the prefabricated zirconia and the titanium abutment but the mean vertical gap was not even measureable. The screw seats were clearly formed but did not match with abutment screws in prefabricated zirconia abutments. They were not, however, precisely formed in the case of customized zirconia abutments. Conclusion: Within the limitations of this study, the prefabricated titanium abutments showed better fit than the zirconia abutments, regardless of customized or prefabricated. Also, the customized zirconia abutments showed significantly higher marginal gaps and the fit was less accurate between screws and screw seats than the prefabricated abutments, titanium and zirconia.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.2
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• pp.113-124
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• 2023

Purpose. The purpose of this study is to help increase the success rate by analyzing the types and characteristics of implant prosthesis and the survival rate. Materials and methods. Among implants placed between 2011 and 2020 at Sanbon Dental Hospital, College of Dentistry, Wonkwang University, a case restored by a prosthetic surgeon was investigated for the characteristics and correlation of failure. The causes of failure were classified as failure of osseointegration, peri-implantitis, fixture fracture, abutment fracture, screw fracture, screw loosening, prosthesis fracture, and loss of prosthesis retention. Prosthetic method, cantilever presence, placement location, etc. were analyzed for their correlation with implant failure. Results analysis was derived through Chi-square test and Kaplan-Meier survival analysis using SPSS ver 25.0 (IBM, Chicago, IL, USA). Results. A total of 2587 implants were placed, of which 1141 implants were restored with Single Crown and 1446 implants with Fixed Partial Denture, and the cumulative survival rate was 88.1%. The success rate of SC was 86.2% (984) and the success rate of FPD was 89.6% (1295), showing statistically significant differences, among which factors that had significant differences were abutment fracture, screw fracture, and screw loosening (P < .05). Conclusion. As a result of the 10-year follow-up, more failures occurred due to biomechanical factors than biological factors. Further studies on the success of implants will be needed in the future.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.3
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• pp.206-214
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• 2014

This study is to evaluate how different bearing surface angles of abutment screw affect the mechanical stability of the joint in the conical seal design implant system. Materials and Methods: Internal connection type regular implants, two-piece cemented type abutments and tungsten carbide/carbon-coated titanium alloy abutment screws were selected. Titanium alloy screws with conical ($45^{\circ}$) and flat ($90^{\circ}$) head designs which fit on to abutment were fabricated. The abutments were tightened to implants with 30 Ncm by digital torque gauge. The loading was applied once to the central axis of abutment. The mean axial displacement was measured using micrometer before and after the tightening and loading (n = 5). The abutment was tightened to implants with 30 Ncm and T-shape stainless steel crown was cemented. Then the change in the amount of reverse-torque was measured after the repeated loading to the central axis, and the place 5 mm away from the central axis. Compressive bending and fatigue strength were measured at the place 5 mm away from the central axis (n = 5). Results: Both groups showed the largest axial displacement when abutment screw tightening and total displacement was greater in the flat head group compared to conical head group (P < 0.05). However, there were no significant differences in reverse torque value, compressive bending and fatigue strength (P > 0.05). Conclusion: Within the limitations of this study, the abutment screw head design had no effect on two groups regarding the joint stability, however the conical head design affected the settlement of abutment resulting in the reduced total displacement.