• Journal of Korean Neurosurgical Society
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• v.49 no.1
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• pp.75-78
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• 2011

We report a case of pedicle screw loosening treated by modified transpedicular screw augmentation technique using polymethylmethacrylate(PMMA), which used the anchoring effect of hardened PMMA. A 56-year-old man who had an L3/4/5 fusion operation 3 years ago complained of continuous low back pain after this operation. The computerized tomography showed a radiolucent halo around the pedicle screw at L5. We augmented the L5 pedicle screw with modified pedicle screw augmentation technique using PMMA and performed an L3/4/5 pedicle screw fixation without hook or operation field extension. This modified technique is a kind of transpedicular stiffness augmentation using PMMA for the dead space around the loosed screw. After filling the dead space with 1-2 cc of PMMA, we inserted a small screw. Once the PMMA hardened, we removed the small screw and inserted a thicker screw along the existing screw threading to improve the pedicle screws' pullout strength. At 10 months' follow-up, x-ray showed strong fusion of L3/4/5. The visual analogue scale (VAS) of his back pain was improved from 9 to 5. This modified transpedicular screw augmentation with PMMA using anchoring effect is a Simple and effective surgical technique for pedicle screw loosening. However, clinical analyses of long-term follow-up and biomechanical studies are needed.

• Journal of the Korean Geotechnical Society
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• v.27 no.7
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• pp.35-45
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• 2011

Cost effective design and construction are necessary to establish the design concept of tunnel lining. Loosening load acting on the concrete lining is compared with Terzaghi tunnel theory and numerical analysis. It is analyzed under the condition of weathered rock and soil with varying in-situ stress ratio ($K_0$). Based on the result, loosening load calculated by Tcrzaghi tunnel theory is much greater than numerical analysis results. And the load calculated in weathered soil is lager than weathered rock condition. As in-situ stress ratio increases, the stress acting on the tunnel lining decreases in Terzaghi theory rapidly, whereas there is little effect in numerical analysis.

• The Journal of Korean Academy of Prosthodontics
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• v.41 no.3
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• pp.351-359
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• 2003

Statement of problem: Regardless of any restoration, most of case, we used in screw connection between abutment and implant. For this reason, implant screw loosening has been remained problem in restorative practices. Purpose: The purpose of this study was to compare surface of coated/plated screw with titanium and gold alloy screw and to evaluate physical property of coated/plated material after scratch test in FESEM investigation Material and methods: GoldTite, titanium screw provided by 3i (Implant Innovation, USA) and TorqTite, titanium screw by Steri-Oss (Nobel Biocare, USA) and gold screw, titanium screw by AVANA (Osstem Implant, korea) - were selected for this study. Each abutment screw surface was observed at 100 times, and then screw crest, root, and slope were done more detailed numerical value, at 1000 times with FESEM. A micro-diamond needle was also prepared for the scratch test. Each abutment screw was fixed, micro-diamond scratch the surface of head region was made at constant load and then was observed central region and periphery of fine trace through 1000 times with FESEM. Results: The surface of GoldTite was smoother than that of other kinds of screw and had abundant ductility and malleability compared with titanium and gold screw. The scratch test also showed that teflon particles were exfoliated easily in screw coated with teflon. Titanium screw had a rough surface and low ductility. Conclusion: It was recommended that the clinical use of gold-plated screw would prevent a screw from loosening. CLINICAL IMPLICATIONS Clinical use of gold-plated screw would prevent a screw from loosening because it had abundant ductility and malleability compared with titanium and gold screw.

• Journal of the Korean Society of Industry Convergence
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• v.20 no.2
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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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• v.10 no.6
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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.

• The Journal of Advanced Prosthodontics
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• v.12 no.6
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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.

• The Journal of Advanced Prosthodontics
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• v.9 no.2
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• pp.99-103
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• 2017

PURPOSE. The purpose of this study was to achieve more retention and stability and to delay or prevent screw loosening. MATERIALS AND METHODS. Twenty implants (Implantium 3.4 mm, Dentium, Seoul, Korea) were divided into 2 groups (n = 20). In the first group, an adhesive material was applied around the screw of the abutments (test group). In the second group, the screws are soaked in saliva (control group). All the screws were torqued under 30 N/cm, Then, the samples were gone through a cyclic fatigue loading process. After cyclic loading, we detorqued screws and calculated detorque value. RESULTS. In comparison with the control group, all the implant screws in the test group were smeared with the adhesive material, showing significant higher detorque value. CONCLUSION. There are significantly higher detorque values in the group with adhesive. It is recommended to make biocompatible adhesive to reduce screw loosening.

• Structural Engineering and Mechanics
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• v.55 no.3
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• pp.639-654
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• 2015

Bolted joints are essential elements of mechanical structures and metal constructions. Although their static behaviour is fairly well known, their dynamic behaviour due to shocks and vibrations has been less studied, because of the large size of the finite element models needed for a detailed simulation. This work presents four different simplified models suitable for studying the dynamic behaviour of an elementary bolted joint. Three of them include contact elements to allow sliding of the screw head and the nut on the assembled parts, and the last one allows rotation between screw and nut. A penalty approach based on the Coulomb friction model is used to model contact. The results show that these models effectively represent the dynamic behaviour, with different accuracy depending on the model details. The last model simulates the self loosening of a bolt subjected to transversal vibrations.

• The Journal of Advanced Prosthodontics
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• v.7 no.3
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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.

• Journal of Biomedical Engineering Research
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• v.22 no.6
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• pp.519-526
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• 2001

At present. about 0.3 million and more THRs (Total Hip Replacement) in a rear are being done worldwide. The increase in mechanical failure with the increase in THR, required more revisions. Revisions compensate mainly the wear of the artificial joint frictional surface and the loosening of the cup and stem. According to recent researches, loosening is mainly due to wear debris UHMWPE (Ultra High Molecular Weight Polyethylene) from frictional surfaces . To overcome the wear problems associated with artificial joint materials , new surface structures with regular Patterns were designed and fabricated The lubrication Properties were examined to evaluate the wear of the frictional surfaces. The surface structure manifested a Pattern of "dents" with a 0.2-1.0 mm of diameter and 0.6-2.0 mm of Pitch. From the friction test of the SUS316L vs UHMWPE using the frictional tester, we found that the lubrication Performance was improved due to of drastically reduced amount of abrasion. There were optimum sizes for the diameter and the pitch of the Pattern. The results demonstrated that the lubrication properties could be improved by Patterning of the frictional surfaces. The surface Patterning was effective in preventing wear of the frictional surfaces, and the life of an artificial joint could be extended with such Patterning.