Effect of Dynamic Cycles and Abutment Angle on The Screw Stability of Standard and Narrow Implants: An In vitro Study
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Abstract
Objective: Screw loosening in implant-supported crowns is a common issue, leading to potential mechanical and biological complications. This study aimed to evaluate the combined influence of cyclic loading, abutment angulation, and implant diameter on screw torque loss in dental implants.
Material and Methods: A total of 80 bone-level implants, divided into standard and narrow diameters, underwent cyclic loading protocols. These implants were paired with straight and 15-degree angled abutments. The study assessed the reverse torque values (RTV) before and after loading, with a primary focus on the effects of cyclic loading, abutment angulation, and implant diameter on screw torque loss.
Results: Cyclic loading protocols and screw diameter significantly influenced screw torque loss. Standard diameter implants exhibited higher RTV compared to narrow diameter implants. . While the role of abutment angulation was less definitive, narrow diameter implants with angled placements showed a pronounced decrease in RTV. The study also highlighted that even with optimal preload values, a percentage of the initial preload is lost, potentially leading to screw loosening
Conclusion: Cyclic loading and screw diameter are pivotal determinants of screw torque loss in dental implants. The study underscores the need for careful consideration of implant diameter and abutment angulation, especially in narrow diameter implants with angled abutments, to ensure optimal implant stability.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Accepted 2023-10-29
Published 2023-10-30
References
Jacobs N, Seghi R, Johnston WM, Yilmaz B. Displacement and performance of abutments in narrow-diameter implants with different internal connections. The Journal of Prosthetic Dentistry. 2022;127(1):100-6. DOI: https://doi.org/10.1016/j.prosdent.2020.11.008
Yilmaz B, Çakmak G, Batak B, Johnston WM. Screw stability of CAD-CAM titanium and zirconia abutments on different implants: An in vitro study. Clinical Implant Dentistry and Related Research. 2021;23(3):373-9. DOI: https://doi.org/10.1111/cid.13001
Jörnéus L, Jemt T, Carlsson L. Loads and designs of screw joints for single crowns supported by osseointegrated implants. The International Journal of Oral & Maxillofacial Implants. 1992;7(3):353-9.
McGlumphy EA, Mendel DA, Holloway JA. Implant screw mechanics. Dental clinics of North America. 1998;42(1):71-89. DOI: https://doi.org/10.1016/S0011-8532(22)00606-1
Yilmaz B, Gouveia D, Seghi RR, Johnston WM, Lang LA. Effect of crown height on the screw joint stability of zirconia screw-retained crowns. The Journal of Prosthetic Dentistry. 2022;128(6):1328-34. DOI: https://doi.org/10.1016/j.prosdent.2021.02.027
Huang Y, Wang J. Mechanism of and factors associated with the loosening of the implant abutment screw: A review. Journal of Esthetic and Restorative Dentistry. 2019;31(4):338-45. DOI: https://doi.org/10.1111/jerd.12494
Lang LA, Kang B, Wang R-F, Lang BR. Finite element analysis to determine implant preload. The Journal of Prosthetic Dentistry. 2003;90(6):539-46. DOI: https://doi.org/10.1016/j.prosdent.2003.09.012
Delben JA, Gomes EA, Barão VA, Assunção WG. Evaluation of the effect of retightening and mechanical cycling on preload maintenance of retention screws. The International Journal of Oral & Maxillofacial Implants. 2011;26(2):251-6.
Yilmaz B, Batak B, Seghi R, Johnston WM, Lang LA. Effect of Crown Height on the Screw Stability of Titanium Screw-Retained Crowns. Journal of Prosthodontics. 2021;30(6):515-9. DOI: https://doi.org/10.1111/jopr.13352
Jaarda MJ, Razzoog ME, Gratton DG. Effect of preload torque on the ultimate tensile strength of implant prosthetic retaining screws. Implant Dentistry. 1994;3(1):17-21. DOI: https://doi.org/10.1097/00008505-199404000-00002
Winkler S, Ring K, Ring JD, Boberick KG. Implant screw mechanics and the settling effect: overview. The Journal of Oral Implantology. 2003;29(5):242-5. DOI: https://doi.org/10.1563/1548-1336(2003)029<0242:ISMATS>2.3.CO;2
Kim KS, Lim YJ. Axial Displacements and Removal Torque Changes of Five Different Implant-Abutment Connections under Static Vertical Loading. Materials (Basel, Switzerland). 2020;13(3). DOI: https://doi.org/10.3390/ma13030699
Feitosa PCP, de Lima APB, Silva-Concílio LR, Brandt WC, Claro Neves AC. Stability of external and internal implant connections after a fatigue test. European Journal Of Dentistry. 2013;7(3):267-71. DOI: https://doi.org/10.4103/1305-7456.115407
Tsuge T, Hagiwara Y. Influence of lateral-oblique cyclic loading on abutment screw loosening of internal and external hexagon implants. Dental Materials Journal. 2009;28(4):373-81. DOI: https://doi.org/10.4012/dmj.28.373
Attiah EMN, AlGendy AA, Mostafa TMN. Effect of dynamic cyclic loading on screw loosening of retightened versus new abutment screw in both narrow and standard implants (in-vitro study). International Journal of Implant Dentistry. 2020;6(1):30. DOI: https://doi.org/10.1186/s40729-020-00229-3
Katsuta Y, Watanabe F. Abutment screw loosening of endosseous dental implant body/abutment joint by cyclic torsional loading test at the initial stage. Dental Materials Journal. 2015;34(6):896-902. DOI: https://doi.org/10.4012/dmj.2015-023
Pellew J, Dudley J. A Comparison of Abutment Screw Loosening in 24-Degree Angulation-Correcting and Straight Implants: An In Vitro Study. The International Journal of Prosthodontics. 2023. DOI: https://doi.org/10.11607/ijp.8463
Ožiūnas R, Sakalauskienė J, Jegelevičius D, Janužis G. A comparative biomechanical study of original and compatible titanium bases: evaluation of screw loosening and 3D-crown displacement following cyclic loading analysis. Journal of Advance Prosthodontics. 2022;14(2):70-7. DOI: https://doi.org/10.4047/jap.2022.14.2.70
Al-Zordk W, Al-Dobaisi T, Ghazy M. Torque Maintenance of Screw-Retained Implant-Supported Anterior Fixed Dental Prosthesis with Different Abutment Angulations After Aging. The International Journal Of Oral & Maxillofacial Implants. 2021;36(4):723-9. DOI: https://doi.org/10.11607/jomi.8647
Jalalian E, Zarbakhsh A, Zare S, Karimi Pour H. Effect of Lateral Cyclic Loading on Screw Loosening in Morse Taper Implant-Straight Abutment Connection. European Journal of Dental and Oral Health. 2022;3(2):30-4. DOI: https://doi.org/10.24018/ejdent.2022.3.2.177
Mulla SH, Seghi RR, Johnston WM, Yilmaz B. Effect of cyclic loading on reverse torque values of angled screw channel systems. The Journal of Prosthetic Dentistry. 2022;128(3):458-66. DOI: https://doi.org/10.1016/j.prosdent.2020.12.020
Rho JY, Ashman RB, Turner CH. Young's modulus of trabecular and cortical bone material: Ultrasonic and microtensile measurements. Journal of Biomechanics. 1993;26(2):111-9. DOI: https://doi.org/10.1016/0021-9290(93)90042-D
Donmez MB, Diken Turksayar AA, Olcay EO, Sahmali SM. Fracture Resistance of Single-Unit Implant-Supported Crowns: Effects of Prosthetic Design and Restorative Material. Journal of Prosthodontics. 2022;31(4):348-55. DOI: https://doi.org/10.1111/jopr.13415
Sun F, Cheng W, Zhao B-h, Song G-Q, Lin Z. Evaluation the loosening of abutment screws in fluid contamination: an in vitro study. Scientific Reports. 2022;12(1):10797. DOI: https://doi.org/10.1038/s41598-022-14791-w
Nasrin S, Katsube N, Seghi RR, Rokhlin SI. Approximate relative fatigue life estimation methods for thin-walled monolithic ceramic crowns. Dental Materials. 2018;34(5):726-36. DOI: https://doi.org/10.1016/j.dental.2018.01.020
Hernandez AI, Roongruangphol T, Katsube N, Seghi RR. Residual interface tensile strength of ceramic bonded to dentin after cyclic loading and aging. The Journal of Prosthetic Dentistry. 2008;99(3):209-17. DOI: https://doi.org/10.1016/S0022-3913(08)60045-1
Swamidass RS, Kan JYK, Kattadiyil MT, Goodacre CJ, Lozada J. Abutment screw torque changes with straight and angled screw-access channels. The Journal of Prosthetic Dentistry. 2021;125(4):675-81. DOI: https://doi.org/10.1016/j.prosdent.2020.01.018
Ricciardi Coppedê A, de Mattos Mda G, Rodrigues RC, Ribeiro RF. Effect of repeated torque/mechanical loading cycles on two different abutment types in implants with internal tapered connections: an in vitro study. Clinical oral implants research. 2009;20(6):624-32. DOI: https://doi.org/10.1111/j.1600-0501.2008.01690.x
Cardoso M, Torres MF, Lourenço EJ, de Moraes Telles D, Rodrigues RC, Ribeiro RF. Torque removal evaluation of prosthetic screws after tightening and loosening cycles: an in vitro study. Clinical Oral İmplants Research. 2012;23(4):475-80. DOI: https://doi.org/10.1111/j.1600-0501.2011.02165.x
Cho WR, Huh YH, Park CJ, Cho LR. Effect of cyclic loading and retightening on reverse torque value in external and internal implants. Journal of Advance Prosthodontics. 2015;7(4):288-93. DOI: https://doi.org/10.4047/jap.2015.7.4.288
Allum SR, Tomlinson RA, Joshi R. The impact of loads on standard diameter, small diameter and mini implants: a comparative laboratory study. Clinical Oral İmplants Research. 2008;19(6):553-9. DOI: https://doi.org/10.1111/j.1600-0501.2007.01395.x
Sousa MP, Tribst JPM, de Oliveira Dal Piva AM, Borges ALS, de Oliveira S, da Cruz PC. Capacity to Maintain Placement Torque at Removal, Single Load-to-Failure, and Stress Concentration of Straight and Angled Abutments. The International Journal of Periodontics & Restorative Dentistry. 2019;39(2):213-8. DOI: https://doi.org/10.11607/prd.3998
Shemtov-Yona K, Rittel D, Levin L, Machtei EE. Effect of dental implant diameter on fatigue performance. Part I: mechanical behavior. Clinical Implant Related Research. 2014;16(2):172-7
Zipprich H, Rathe F, Pinz S, Schlotmann L, Lauer HC, Ratka C. Effects of Screw Configuration on the Preload Force of Implant-Abutment Screws. The International journal of oral & maxillofacial implants. 2018;33(2):e25-e32. DOI: https://doi.org/10.11607/jomi.5837