• The Journal of Advanced Prosthodontics
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• 제5권1호
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• pp.21-28
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• 2013

PURPOSE. This study examined the effects of the abutment types and dynamic loading on the stability of implant prostheses with three types of implant abutments prepared using different fabrication methods by measuring removal torque both before and after dynamic loading. MATERIALS AND METHODS. Three groups of abutments were produced using different types of fabrication methods; stock abutment, gold cast abutment, and CAD/CAM custom abutment. A customized jig was fabricated to apply the load at $30^{\circ}$ to the long axis. The implant fixtures were fixed to the jig, and connected to the abutments with a 30 Ncm tightening torque. A sine curved dynamic load was applied for $10^5$ cycles between 25 and 250 N at 14 Hz. Removal torque before loading and after loading were evaluated. The SPSS was used for statistical analysis of the results. A Kruskal-Wallis test was performed to compare screw loosening between the abutment systems. A Wilcoxon signed-rank test was performed to compare screw loosening between before and after loading in each group (${\alpha}$=0.05). RESULTS. Removal torque value before loading and after loading was the highest in stock abutment, which was then followed by gold cast abutment and CAD/CAM custom abutment, but there were no significant differences. CONCLUSION. The abutment types did not have a significant influence on short term screw loosening. On the other hand, after $10^5$ cycles dynamic loading, CAD/CAM custom abutment affected the initial screw loosening, but stock abutment and gold cast abutment did not.

• 한국산업융합학회 논문집
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• 제20권2호
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• pp.169-176
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• 2017

Dental implants are required to have biomechanical functions and biostability in order to perform authoring, pronunciation, and aesthetic functions in the oral cavity. In terms of biostability, pure titanium for medical have good biostability and no rejection in the alveolar bone. with appropriate strength in terms of strength as well as biocompatibility. In recent years, various surgical methods and devices have been developed to improve the convenience and safety of the procedure. However, as the number of procedures increases, the screw loosening of the abutment screw connecting the artificial root and the abutment There are many reports of artificial root and abutment fracture. Fig. 1 is an example of a case where the upper part of the abutment screw is arbitrarily modified to remove the abutment by the abutment fracture due to the loosening of the abutment screw. The fundamental cause of abduction of the abutment screw is caused by the slight movement due to the lowering of the retention force of the abutment screw. It is necessary to minimize loosening of the abutment screw to avoid problems such as fracture during the period of using the implant. The purpose of this study is to investigate the structure of the abutment screw to prevent the loosening of the abutment screw by forming 0.5mm slot.

• The Journal of Advanced Prosthodontics
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• 제10권6호
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• pp.415-421
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• 2018

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.

• 대한치과의사협회지
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• 제53권5호
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• pp.307-317
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• 2015

Although the long-term success of osseointegrated endosseous implants for the support of fixed dental prostheses has been reported, the increasingly widespread use of implant-supported prostheses has led to problems associated with their structural integrity. The most common biomechanical complications observed in dental implant treatment are fracture and screw loosening. The nature of loosening or fracture of dental implant components is complex, since it involves fatigue, fitness, and varied chewing patterns and loads. To assess the service life of the components of the prosthetic system, a knowledge of the loads transmitted through the system is necessary. Design of the final restoration and occlusion in relation to the geometry of a prosthetic restoration has a great influence on the mechanical loading of the implant. It is proposed that control of force in oral cavity may play a larger role in failures than previously believed. Based on theoretic consideration and clinical experiences with dental implant, this article gives simple guidelines for controlling these loads.

• The Journal of Advanced Prosthodontics
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• 제7권5호
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• pp.375-379
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• 2015

PURPOSE. The purpose of this study was to evaluate the influence of tightening technique and the screw coating on the loosening torque of screws used for Universal Abutment fixation after cyclic loading. MATERIALS AND METHODS. Forty implants (Titamax Ti Cortical, HE, Neodent) (n=10) were submerged in acrylic resin and four tightening techniques for Universal Abutment fixation were evaluated: A - torque with 32 Ncm (control); B - torque with 32 Ncm holding the torque meter for 20 seconds; C - torque with 32 Ncm and retorque after 10 minutes; D - torque (32 Ncm) holding the torque meter for 20 seconds and retorque after 10 minutes as initially. Samples were divided into subgroups according to the screw used: conventional titanium screw or diamond like carbon-coated (DLC) screw. Metallic crowns were fabricated for each abutment. Samples were submitted to cyclic loading at $10^6$ cycles and 130 N of force. Data were analyzed by two-way ANOVA and Tukey's test (5%). RESULTS. The tightening technique did not show significant influence on the loosening torque of screws (P=.509). Conventional titanium screws showed significant higher loosening torque values than DLC (P=.000). CONCLUSION. The use of conventional titanium screw is more important than the tightening techniques employed in this study to provide long-term stability to Universal Abutment screws.

• 구강회복응용과학지
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• 제35권3호
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• pp.132-142
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• 2019

목적: 본 유한요소해석적 연구는 새로운 Lock screw 시스템을 소개하고 그 역학적 특성을 분석하여 Lock screw가 지대주 나사 풀림을 방지할 수 있는지 알아보려고 한다. 연구 재료 및 방법: Lock screw는 임플란트 지대주 내부에 체결하여 지대주 나사 두부에 압축력을 가하는 장치이다. 그 효과를 알아보기 위해 CAD 프로그램을 이용하여 모델링을 하였고, 이를 다양한 하중조건 하에서 유한요소해석법을 이용해 분석하였다. 우선 지대주 나사의 조임회전력에 따른 전하중을 측정하고 이론 값과 비교하여 해석모델을 검증하였다. 검증된 해석 모델을 외부 하중이 없는 것과 178 N을 부여한 것으로 나누어 Lock screw의 조임회전력을 각각 10, 20, 30 Ncm으로 변화시켰고, 이때 임플란트 구성요소의 응력 분포가 어떠한 특성을 보이는지 살펴보았다. 결과: 여러 하중조건 하에서 Lock screw의 사용은 임플란트 구성요소의 항복강도를 넘어서는 등가응력을 발생시키지 않았다. 또한 지대주-지대주 나사 계면에서 축방향 하중의 증가를 보였다. 결론: Lock screw의 사용은 임플란트 구성요소에 과도한 응력을 가하지 않으며, 지대주-지대주 나사 계면의 마찰력을 증가시켜 지대주 나사 풀림을 방지할 수 있을 것으로 판단된다.

• 대한치과보철학회지
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• 제45권2호
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• pp.240-249
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• 2007

Statement of problem: A phenomenon of screw-loosening in implant abutment is frequently occurred in a single and multiple implant restoration. Purpose: This study was performed to evaluate an effect of abutment material on screw-loosening before and after a cyclic loading. In a single-tooth implant, different materials of abutment, Type III Gold alloy and Zirconium composite$(ZrO_2/Al_2O_3)$ were used. Material and method: The Gold alloy(Type III) and Zirconium composite$(ZrO_2/Al_2O_3)$ were used to make a superstructure of implant, the one of types of UCLA, Each group was constituted of 5 sample with a 30-degree offset angulated loading platform. The external hexagonal fixture was rigidly hel d in a special holding zig to ensure solid fixation without rotation during the tightening and a cyclic loading. A Titanium-alloy screw was used to connect and controlled to be tighten in 20Ncm torque by a digital torque gauge. A 20 times of consecutive closing/opening cycle were performed to evaluate the immediate torque loss. In 5 sample of each material group, an initial opening torque was recorded during 3 closing/opening cycle, then 2Hz, 200N, 1,000,000 cyclic loadings were performed, then a opening torque was evaluated. Result & Conclusion: 1. In this limited study, titanium alloy screw tightened in 20Ncm, a cold-welding phenomen on was not observed during the 20 times of closing/opening cycle(p=0.11, p=0.18). 2. In titanium alloy abutment screw, repeated opening and closing of the screw caused to progressive decrease of opening torque(p=0.014). 3. The difference in preload of screw between gold alloy abutment and ceramic$(ZrO_2/Al_2O_3)$ abutment was not significant(p=0.78). 4. The difference in torque loss of screw between gold alloy abutment and ceramic$(ZrO_2/Al_2O_3)$ abutment was not significant after 2Hz,200N, 1,000,000 cyclic loading(p=0.92). 5. In titanium alloy abutment screw tightened by 20Ncm, the screw loosening was not significant on each group after 2Hz, 200Ncm, 1,000,000 cyclic loading(p=0.59).

• The Journal of Advanced Prosthodontics
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• 제7권3호
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• pp.207-213
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• 2015

PURPOSE. The purpose of this study was to examine the abutment screw stability of screw- and cement-retained implant-supported dental prosthesis (SCP) after simulated cement washout as well as the stability of SCP cements after complete loosening of abutment screws. MATERIALS AND METHODS. Thirty-six titanium CAD/CAM-made implant prostheses were fabricated on two implants placed in the resin models. Each prosthesis is a two-unit SCP: one screw-retained and the other cemented. After evaluating the passive fit of each prosthesis, all implant prostheses were randomly divided into 3 groups: screwed and cemented SCP (Control), screwed and non-cemented SCP (Group 1), unscrewed and cemented SCP (Group 2). Each prosthesis in Control and Group 1 was screwed and/or cemented, and the preloading reverse torque value (RTV) was evaluated. SCP in Group 2 was screwed and cemented, and then unscrewed (RTV=0) after the cement was set. After cyclic loading was applied, the postloading RTV was measured. RTV loss and decementation ratios were calculated for statistical analysis. RESULTS. There was no significant difference in RTV loss ratio between Control and Group 1 (P=.16). No decemented prosthesis was found among Control and Group 2. CONCLUSION. Within the limits of this in vitro study, the stabilities of SCP abutment screws and cement were not significantly changed after simulated cement washout or screw loosening.

• 대한치과보철학회지
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• 제41권4호
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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 Advanced Prosthodontics
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• 제12권6호
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• pp.329-337
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• 2020

PURPOSE. To verify the influence of computer-aided design/computer-aided manufacturing (CAD/CAM) implant-supported prostheses manufactured with cobalt-chromium (Co-Cr) and zirconia (Zr), and whether ceramic application, spark erosion, and simulation of masticatory cycles modify biomechanical parameters (marginal fit, screw-loosening torque, and strain) on the implant-supported system. MATERIALS AND METHODS. Ten full-arch fixed frameworks were manufactured by a CAD/CAM milling system with Co-Cr and Zr (n=5/group). The marginal fit between the abutment and frameworks was measured as stated by single-screw test. Screw-loosening torque evaluated screw stability, and strain analysis was explored on the implant-supported system. All analyses were performed at 3 distinct times: after framework manufacturing; after ceramic application in both materials' frameworks; and after the spark erosion in Co-Cr frameworks. Afterward, stability analysis was re-evaluated after 106 mechanical cycles (2 Hz/150-N) for both materials. Statistical analyses were performed by Kruskal-Wallis and Dunn tests (α=.05). RESULTS. No difference between the two materials was found for marginal fit, screwloosening torque, and strain after framework manufacturing (P>.05). Ceramic application did not affect the variables (P>.05). Spark erosion optimized marginal fit and strain medians for Co-Cr frameworks (P<.05). Screw-loosening torque was significantly reduced by masticatory simulation (P<.05) regardless of the framework materials. CONCLUSION. Co-Cr and Zr frameworks presented similar biomechanical behavior. Ceramic application had no effect on the biomechanical behavior of either material. Spark erosion was an effective technique to improve Co-Cr biomechanical behavior on the implant-supported system. Screw-loosening torque was reduced for both materials after masticatory simulation.