• The Journal of Advanced Prosthodontics
• /
• v.13 no.1
• /
• pp.65-70
• /
• 2021

Purpose. Implant mechanical complications, including screw loosening, can influence dental implant success. It has been shown that torque values are affected by contamination occurred in implant-abutment (I/A) interface. This study aimed to examine the effects of blood, saliva, fluoride and chlorhexidine contamination on reverse torque values (RTVs) of abutment screws in oral conditions. Materials and Methods. 50 fixtures were mounted into the stainless-steel holders and divided into five groups (n = 10). Except control group (NC), fixture screw holes in other groups were contaminated with chlorhexidine (CG), saliva (SG), blood (BG), or fluoride (FG). Abutment screws were tightened with a digital torque meter. I/A assemblies were subjected to thermocycling and cyclic loading. The mean RTVs were recorded and data were analyzed with one-way ANOVA and Tukey test. Results. Except for specimens in SG (20.56 ± 1.33), other specimens in BG (21.11 ± 1.54), CG (22.89 ± 1.1) and FG (24.00 ± 1.12) displayed significantly higher RTVs compared to NC (19.00 ± 1.87). The highest RTVs were detected in CG and FG. Conclusion. The obtained data robustly suggest that RTVs were significantly affected by fluid contaminations. Specimens in FG and CG displayed the highest RTVs. Therefore, clinicians should have enough knowledge about probable contaminations in I/A interface in order to manage them during clinical procedure and to inform patients about using oral care products.

• The Journal of Advanced Prosthodontics
• /
• v.14 no.2
• /
• pp.70-77
• /
• 2022

PURPOSE. This study evaluated screw loosening and 3D crown displacement after cyclic loading of implant-supported incisor crowns cemented with original titanium bases or with three compatible, nonoriginal components. MATERIALS AND METHODS. A total of 32 dental implants were divided into four groups (n = 8 each): Group 1 used original titanium bases, while Groups 2-4 used compatible components. The reverse torque value (RTV) was evaluated prior to and after cyclic loading (1,200,000 cycles). Samples (prior to and after cyclic loading) were scanned with a microcomputed tomography (micro-CT). Preload and postload files were superimposed by 3D inspection software, and 3D crown displacement analysis was performed using root-mean-square (RMS) values. All datasets were analyzed using one-way ANOVA and Tukey's post hoc analysis. RESULTS. Significant variations were observed in the postload RTV, depending on the titanium base brand (P < .001). The mean postload RTVs were significantly higher in Groups 1 and 2 than in the other study groups. While evaluating 3D crown displacement, the lowest mean RMS value was shown in the original Group 1, with the highest RMS value occurring in Group 4. CONCLUSION. Within the limitations of this in vitro study and under the implemented conditions, it was concluded that the manufacturer brand of the titanium base significantly influenced screw loosening following the fatigue test and influenced 3D crown displacement after cyclic loading.

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

• Journal of Dental Rehabilitation and Applied Science
• /
• v.26 no.2
• /
• pp.97-109
• /
• 2010

Purpose : This study was designed to evaluate the influence of implant abutment materials on detorque value and screw joint stability before and after dynamic fatigue test. Materials & Methods : The external hexagonal fixture and three different groups of abutment (titanium abutments, zirconia abutments, and UCLA abutments) were used. The detorque value before loading and after loading (cyclic loading up to $10^5$ cycles) of the abutment screw were measured. Result : 1. There was no significant difference in detorque value before loading among the each group. 2. There was no significant difference in detorque value after loading among the each group. 3. Detorque values before and after cyclic loading in each group were not significantly different. 4. There was no significant difference in loss percentage of removal torque before loading among the each group. 5. There was no significant difference in loss percentage of removal torque after loading among the each group. 6. There was no significant difference in loss percentage of removal torque according to loading among the each group. Conclusion : Short term screw loosening of three types of abutment was not significantly different. When bite force was applied, there was no significant difference in screw loosening between before loading and after loading.

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

• Journal of Korean Neurosurgical Society
• /
• v.53 no.1
• /
• pp.26-30
• /
• 2013

Objective : The purpose of this study was to compare the results of three types of short segment screw fixation for thoracolumbar burst fracture accompanying osteopenia. Methods : The records of 70 patients who underwent short segment screw fixation for a thoracolumbar burst fracture accompanying osteopenia (-2.5< mean T score by bone mineral densitometry <-1.0) from January 2005 to January 2008 were reviewed. Patients were divided into three groups based on whether or not bone fusion and bone cement augmentation procedure 1) Group I (n=26) : short segment fixation with posterolateral bone fusion; 2) Group II (n=23) : bone cement augmented short segment fixation with posterolateral bone fusion; 3) Group III (n=21) : bone cement augmented, short segment percutaneous screw fixation without bone fusion. Clinical outcomes were assessed using a visual analogue scale and modified MacNab's criteria. Radiological findings, including kyphotic angle and vertebral height, and procedure-related complications, such as screw loosening or pull-out, were analyzed. Results : No significant difference in radiographic or clinical outcomes was noted between patients managed using the three different techniques at last follow up. However, Group I showed more correction loss of kyphotic deformities and vertebral height loss at final follow-up, and Group I had higher screw loosening and implant failure rates than Group II or III. Conclusion : Bone cement augmented procedure can be an efficient and safe surgical techniques in terms of achieving better outcomes with minimal complications for thoracolumbar burst fracture accompanying osteopenia.

• The Journal of the Korean dental association
• /
• v.58 no.9
• /
• pp.583-589
• /
• 2020

If the implant is planted in the wrong position or direction, it is disadvantageous for stress distribution, and it is easy to cause complications such as screw loosening, abutment fracture, and implant fracture. If the position or orientation of the implant is not good, efforts should be made to minimize the problem through proper implant prosthetic treatment. In this article, the prosthetic method for facilitating future maintenance in cases with poor implant placement or orientation will be presented.

• Proceedings of the KSME Conference
• /
• 2007.05a
• /
• pp.636-641
• /
• 2007

This research focuses on the development of an analytical model loosening mechanism of dental implant system. The model is utilized for predictions of preload values for internal and external types of implants. It identifies the effects of various parameters such as friction, geometric factors and mechanical properties on the loosening mechanism of the implant system. The results of analytical model are compared to those of the numerical method for validation.

• Journal of Technologic Dentistry
• /
• v.45 no.4
• /
• pp.124-130
• /
• 2023

This study aims to describe the clinical experience of single and bridge crowns fabricated using a cementless screw-retained implant prosthesis system. In the case of single crown (#37), regular link (HDL) was used, and bridge crowns (#15~#24), (#26~#27), (#17~#14) (#24~#26) were fabricated by selecting regular link and short link considering the vertical height. One abutment was hex shaped to ensure that it could be mounted while preventing insertion and prosthesis rotation. The advantages of cementless implant prosthesis include shorter chair time and periodic care, strong retention with LINK abutment, safety from inflammation, bacterial infection, and complications due to peri-implant cement, and high patient satisfaction. Dentists should double-check the position of the implant fixture and dental technicians should continuously manage the fit of the link and prosthesis with digital equipment to reduce screw loosening and fractures.

• Journal of the Korean Society of Industry Convergence
• /
• v.26 no.4_2
• /
• pp.623-628
• /
• 2023

The purpose of this study was to evaluate the fracture strength and removal torque value (RTV) of a conventional angled abutment and a newly developed angled abutment (Beauty up abutment) with an angulated screw access hole. Each abutment was divided into a control group and an experimental group (n = 20, respectively). To measure the fracture strength, the abutment was connected to the internal hex implant with 30 Ncm torque, and a load was applied at 30 degree angle with cross-head speed of 1 mm/min using a universal testing machine according to the ISO 14801:2016 standard. To measure RTV, each abutment was fastened to the implant with 30 Ncm torque. Retightening was performed after 10 minutes, and initial RTV was measured with a digital torque gauge. After retightening, a load of 250 N was applied to the abutment at a 30 degree angle using a chewing simulator. After a total of 100,000 repeated loads, RTV was measured. Statistical analysis was performed using Wilcoxon signed rank test and Mann-Whitney U test (α = .05). The fracture strength of the experimental group was statistically significantly lower than that of the control group (P = .009). There was no significant difference between initial RTV and post-loading RTV between the experimental group and the control group (P = .753, P = .527, respectively), and cyclic loading did not significantly affect RTV in both groups (P = .078).