THE EFFECT OF INTERNAL IMPLANT-ABUTMENT CONNECTION AND DIAMETER ON SCREW LOOSENING

  • Ha, Chun-Yeo (Department of Prosthodontics, Graduate School, Seoul National University) ;
  • Kim, Chang-Whe (Department of Prosthodontics, Graduate School, Seoul National University) ;
  • Lim, Young-Jun (Department of Prosthodontics, Graduate School, Seoul National University) ;
  • Jang, Kyung-Soo (Department of Prosthodontics, Graduate School, Seoul National University)
  • Published : 2005.06.01

Abstract

Statement of problem. One of the common problems of dental implant prosthesis is the loosening of the screw that connects each component, and this problem is more common in single implant-supported prostheses with external connection, and in molars. Purpose. The purposes of this study were: (1) to compare the initial abutment screw detorque values of the six different implant-abutment interface designs, (2) to compare the detorque values of the six different implant-abutment interface designs after cyclic loading, (3) to compare the detorque values of regular and wide diameter implants and (4) to compare the initial detorque values with the detorque values after cyclic loading. Material and methods. Six different implant-abutment connection systems were used. The cement retained abutment and titanium screw of each system were assembled and tightened to 32Ncm with digital torque gauge. After 10 minutes, initial detorque values were measured. The custom titanium crown were cemented temporarily and a cyclic sine curve load(20 to 320N, 14Hz) was applied. The detorque values were measured after cyclic loading of one million times by loading machine. One-way ANOVA test, scheffe’s test and Mann-Whitney U test were used. Results. The results were as follows : 1. The initial detorque values of six different implant-abutment connections were not significantly different(p>0.05). 2. The detorque values after one million dynamic cyclic loading were significantly different (p<0.05). 3. The SS-II regular and wide implant both recorded the higher detorque values than other groups after cyclic loading(p<0.05). 4. Of the wide implants, the initial detorque values of Avana Self Tapping Implant, MIS and Tapered Screw Vent, and the detorque values of MIS implant after cyclic loading were higher than their regular counterparts(p<0.05). 5. After cyclic loading, SS-II regular and wide implants showed higher detorque values than before(p<0.05).

Keywords

References

  1. Adell R, Lekholm U, Branemark PI. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981;10:387-416 https://doi.org/10.1016/S0300-9785(81)80077-4
  2. COX JF, Zarb GA. The longitudinal clinical efficacy of osseointegrated dental implants: A 3-year report. Int J Oral Maxillofac Implants 1987;2:91-100
  3. Adell R, Eriksson B, Lekholm U, Branemark PI, Jemt T. A long-term follow-up of osseointegrated implants in the treatment of totally edentulous jaws. Int J Oral Maxillofac Implants 1990;5:347-59
  4. Zarb GA, Schmitt A. The longitudinal clinical effectiveness of osseointegrated implants: The Toronto study. Part Ill . Problems and complications encountered. J Prosthet Dent 1990;64:185-94 https://doi.org/10.1016/0022-3913(90)90177-E
  5. Binon PP. The effect of implant/abutment hexagonal misfit on screw joint stability. Int J Prosthodont 1996;9:149-60
  6. Jemt T. Failures and complications in 391 consecutively inserted fixed prostheses supported by Branemark implants in edentulous jaws: A study of treatment from the time of prosthesis placement to the first annual checkup. Int J Oral Maxillofac Implants 1991;6:270-6
  7. Jemt T. Multicenter study of overdentures supported by Branemark. Int J Oral Maxillofac Implants 1992;7:513-22
  8. Jemt T, Linden B, Lekholm U. Failures and complications in 127 consecutively inserted fixed prostheses supported by Branemark implants: From prostheses treatment to first annual check up. Int J Oral Maxillofac Implants 1992;7:40-3
  9. McGlumphy EA, Mendel DA, Hollowa JA. Implant screw mechanics. Dent Clin North Am 1998;42:71-89
  10. Haack JE, Sakaguchi RL, Coeffy JP. Elongation and preload stress in dental implant abutment screws. Int J Oral Maxillofac Implants 1995;10:529-36
  11. Lang JA, May KB, Wang RF. The effect of the use of a countertorque device on the abutment-implant complex. J Prosthet Dent 1999;81:411-7 https://doi.org/10.1016/S0022-3913(99)80007-9
  12. Artzi Z, Dreiangel A. A screw lock for single-tooth implant superstructures. J Am Dent Assoc 1999;130:677-82 https://doi.org/10.14219/jada.archive.1999.0277
  13. Schwarz MS. Mechanical complications of dental implants. Clin Oral Impl Res 2000;11 Supp11:156-8. Review
  14. Cavazos E, Bell FA. Preventing loosening of implant abutment screws. J Prosthet Dent 1996;75:566-9 https://doi.org/10.1016/S0022-3913(96)90464-3
  15. Jorneus L, Jemt T, Carlsson L. Loads and designs of screw joints for single crowns supported by osseointegrated implants. Int J Oral Maxillofac Implants 1992;7:353-9
  16. Graves SL, Jansen CE, Siddique AA, Beauty KD. Wide diameter implants: indications, considerations and preliminary results over a two-year period. Aust Prost- hodont J 1994;8:31-7
  17. Norton MR. An in vitro evaluation of the strength of an internal conical interface compared to a butt joint design. Clin Oral Impl Res 1997;8:290-8 https://doi.org/10.1034/j.1600-0501.1997.080407.x
  18. Binon PP. Implants and components. Int J Oral Maxillofac Implants 2000;15:633-45
  19. Merz BR, Hunenbart S, Belser UC. Mechanics of the implant-abutment connection: an 8-degree taper compared to a butt joint connection. Int J Oral Maxillofac Implants 2000;15:519-26
  20. Binon PP. Evaluation of machining accuracy and consistency of selected implants, standard abutments, and laboratory analogs. Int J Prosthodont 1995;8:162-78
  21. Barzilay I. The search for intimacy: Rotational accuracy of implant components for single-tooth, root-form implants. Dent Implantol Update 1991;2:5-7
  22. Fenton AH, Zarb GA. Research status of prosthodontic procedures. Int J Prosthodont 1993;6:137-44
  23. Jemt T. Modified single and short span restorations supported by osseointegrated fixtures in the partially edentulous jaw. J Prosthet Dent 1986;55:243-7 https://doi.org/10.1016/0022-3913(86)90352-5
  24. Kallus T, Bessing C. Loose gold screws frequently occur in full arch fixed prostheses supported by osseointegrated implants after 5 years. Int J Oral Maxillofac Implants 1994;9:169-78
  25. Jemt T, Laney WR, Harris D, Henry PJ, Krogh PHJ Jr, Polizzi G, et al. Osseointegrated implants for single tooth replacement: A 1-year report from a multicenter prospective study. Int J Oral Maxillofac Implants 1991;6:29-36
  26. Becker W, Becker BE. Replacement of maxillary and mandibular molars with single endosseous implant restorations: A retrospective study. J Prosthet Dent 1995; 74:51-5 https://doi.org/10.1016/S0022-3913(05)80229-X
  27. Eckert SE, Wollan PC. Retrospective review of 1170 endosseous implants placed in partially edentulous jaws. J Prosthet Dent 1998;79:415-21 https://doi.org/10.1016/S0022-3913(98)70155-6
  28. Niznick GA. The implant abutment connection: The key to prosthetic success. Compend Contin Educ Dent 1991;12: 932-7
  29. Schroeder A, Sutter F, Krekeler G. Oral Implantology. General principles and hollow cylinder system. Stuttgart: Thieme, 1998
  30. Schulte W, d'Hoedt B, Axmann D, Gomez G. The first 15 years of the Tuebingen implant and its further development to the Frialit-2 system. Z Zahnarztl lmplantoI 1992;8:3-22
  31. Arvidson K, Bystedt H, Ericsson I. Histometric and ultrastructural studies of tissues surrounding Astra dental implants in dogs. Int J Oral Maxillofac Implants 1990;5:127-34
  32. Binon PP. The Spline implant: Design, engineering, and evaluation. Int J Prosthodont 1996;9:419-33
  33. Hoyer SA, Stanford CM, Buranadham S, Fridrich T. Wagner J, Gratton D. Dynamic fatigue properties of the dental implant-abutment interface: Joint opening in wide- diameter versus standard-diameter hex-type implants. J Prosthet Dent 2001; 85:599-607 https://doi.org/10.1067/mpr.2001.115250
  34. Mollersten L, Lockowandt P, Linden LA. Comparison of strength and failure mode of seven implant system: An in vitro test. J Prosthet Dent 1997;78:582-91 https://doi.org/10.1016/S0022-3913(97)70009-X
  35. ISO/DIS 14801 Dental implants-Dynamic continuous fatigue test. International Organization for Standardization, 2001
  36. Binon PP, McHugh MJ. The effect of eliminating implant/abutment rotational misfit on screw joint stability. Int J Prost- hodont 1996;9:511-9
  37. Wiskott HW, Nicholls JI, Belser Uc. Stress fatigue: basic principles and prosthodontic implications. Int J Prosthodont 1995;8:105-16
  38. Felton DA. Cemented versus screw-retained implant prostheses: Which is better? [current issues forum]. Int J Oral Maxillofac Implants 1999;14:138-9.
  39. Weinberg LA. The biomechanics of force distribution in implant-supported prostheses. Int J Oral Maxillofac Implants 1993;8:19-31
  40. Weinberg LA, Kruger B. Acomparison of implant-prosthesis loading with four clinical variables. Int J Prosthodont 1995;8:421-33
  41. Binon PP. Implants and components: Entering the new millenium. Int J Oral Maxillofac Implants 2000;15:76-94
  42. Sutter F, Weber HP, Sorensen J, Belser U. The new restorative concept of the ITI dental implant system: design and engineerign. Int J Periodont Rest Dent 1993;13:409-31
  43. Norton MR. Assessment of cold welding properties of the inernal conical interface of two commercially available implant systems. J Prosthet Dent 1999;81:159-66 https://doi.org/10.1016/S0022-3913(99)70243-X
  44. Merz BR, Hunenbart S, Belser UC. Mechanics of the implant-abutment connection: an 8-degree taper compared to a butt joint connection. Int J Oral Maxillofac Implants 2000;15:519-26
  45. Sakaguchi RL, Borgersen SE. Nonlinear contact analysis of preload in dental implant screws. Int J Oral Maxillofac Implants 1995;10:295-302
  46. Burguete RL, Johns RB, King T, Patterson EA. Tightening characteristics for screwed joints in osseointegrated dental implants. J Prosthet Dent 1994;71:592-9 https://doi.org/10.1016/0022-3913(94)90443-X
  47. Arvidson K, Bystedt H, Frykholm A, von Konow L, Lothigus E. A 3-year clinical study of Astra dental implants in the treatment of edentulous mandibles. Int J Oral Maxillofac Implants 1992;7:321-9
  48. Arvidson K, Bystedt H, Frykholm A, von Konow L, Lothigus E. Five year prospective follow-up report of the Astra Tech Dental Implant System in the treatment of edentulous mandibles. Clin Oral Impl Res 1998;9:225-34 https://doi.org/10.1034/j.1600-0501.1998.090403.x
  49. Makkonen TA, Holmberg S, Nieme L, Olsson C, Tammisalo T, Peltola J. A 5-year prospective clinical study of Astra Tech dental implants supporting fixed bridges or overdentures in the edentulous mandible. Clin Oral Impl Res 1997;8:469-75 https://doi.org/10.1034/j.1600-0501.1997.080605.x
  50. Norton M. Marginal bone levels at single tooth implants with a conical fixture design. The influence of surface macro- and microstructure. Clin Oral Impl Res 1998;9:91-9 https://doi.org/10.1034/j.1600-0501.1998.090204.x
  51. Palmer RM, Smith BJ, Palmer PJ, Floyd PD. A prospective study of Astra single tooth implants. Clin Oral Impl Res 1997; 8:173-9 https://doi.org/10.1034/j.1600-0501.1997.080303.x
  52. Jarvis W. Biomechanical advantages of wide diameter implants. Compend Contin Educ Dent 1997;18:687-94