• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.4
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• pp.343-358
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• 2011

As implant treatment has become popular, lots of different shapes and materials of the implant upper component have been supplied. And there are also diverse reports about failures including loosening of the abutment screw which is one of the most common reason. Purpose : The purpose of this study is to find out how different screw tightening orders and methods influence on screw loosening according to the different connection systems. The upper component was fabricated by casting method. After fabricating master models that are precisely attached to the upper component, 5 experimental models each for the external connection system and internal connection system were fabricated using splinting impression technique. First, to find out the influence of the screw tightening order, screws were tightened in 3 orders; 1-2-3-4, 2-3-1-4, 2-4-3-1. After tightening, removal torque values (RTV) of each group was measured. And also to find out the influence of screw tightening method, a model with 2-3-1-4 screw tightening order was tightened with 30 Ncm at one time(1-step method) and the RTV was compared with the same order group (2-3-1-4) in the 2 step method. In the external connection system, RTV appeared significantly lower in group 2-3-1-4 than group 2-4-3-1 (p<0.05). And also in the internal connection system, the RTV of group 2-3-1-4 appeared significantly lower than that of group 2-4-3-1 and 1-2-3-4 (p<0.05). When comparing the tightening number of the screw without considering the screw tightening order, the first tightened screw appeared significantly higher RTV than the second one in the external connection system (p<0.05), however there was no significant difference from the first tightened screw to the last tightened screw in the internal connection system. And there was no statistically significant difference between the two screw tightening methods in both internal and external connection system. In the comparison of external and internal connection system, each RTV appeared 16.27 Ncm and 14.25 Ncm and appeared as a statistically significant difference (p<0.05). There was a significant difference in RTV measured according to the screw tightening order. The lowest RTV appeared in the groups started tightening from the middle. There was also a significant difference in RTV between the two connection system groups. A further study is needed to find out the influence factors in RTV and also a study is required related to the load condition.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.4
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• pp.243-250
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• 2010

Purpose: This study evaluated the effect of different screw tightening sequences and methods on detorque values in a well-fitting implant superstructure. Materials and methods: A fully edentulous mandibular master model and a metal framework directly connected to four parallel implants (Astra Tech) with a passive fit to each other were fabricated. Six stone casts were made with a splinted impression technique to represent a 'well-fitting' situation with the metal framework. Detorque values were measured twice after screw tightening using 20 Ncm. Detorque values and minimum detorque values for three screw tightening sequences (1-2-3-4, 2-4-3-1, and 2-3-1-4) and for two tightening methods (two-step and one-step) were analyzed using multi-way analysis of variance and two-way analysis of variance, respectively, at a .05 level of significance. Results: The mean detorque values for screw tightening sequences ranged from 12.8 Ncm (2-4-3-1) to 13.1 Ncm (2-3-1-4), and for screw tightening methods were 13.1 Ncm (two-step) and 11.8 Ncm (one-step). The mean of mimimum detorque values for screw tightening sequences were 11.1 Ncm (1-2-3-4) and 11.2 Ncm (2-4-3-1 and 2-3-1-4), and for screw tightening methods were 11.2 Ncm (two-step) and 9.9 Ncm (one-step). No statistically significant differences among three screw tightening sequences were found for detorque values and for mimimum detorque values. But, statistically significant differences between two screw tightening methods were found for two values. Two-step screw tightening method showed higher detorque value (P = .0003) and higher minimum detorque value (P = .0035) than one-step method. Conclusion: Within the limitations of this study, the screw tightening sequence was not a critical factor for the detorque values in a well-fitting implant superstructure by the splinted impression technique. But, two-step screw tightening method showed greater detorque values than one-step method.

• 대한치과보철학회:학술대회논문집
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• 2004.11a
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• pp.61-61
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• 2004

• The Journal of Korean Academy of Prosthodontics
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• v.45 no.5
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• pp.653-664
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• 2007

Statement of problem: The screw detorque value is a measure of the preload remaining in the screw just before detorquing. Purpose: This study evaluated the effect of different screw tightening sequences and tightening methods on detorque values for a well-fitting implant superstructure. Material and method: An implant superstructure that connected directly to four implants (Astra Tech) was fabricated on a fully edentulous mandibular acrylic resin model. Six well-fitting dental stone casts were made with a pickup impression of the superstructure from the acrylic resin model. To evaluate the effect of three screw tightening sequences (1-2-3-4, 2-4-3-1, and 2-3-1-4) and two tightening methods (2-step and 1-step) on the stability of screw joint, the detorque values for a well-fitting implant superstructure were measured twice after screw tightening using 20 Ncm. Detorque values were analyzed using multi-way analysis of variance and two-way analysis of variance at a .05 level of significance. Results: 1. The mean detorque values for three screw tightening sequences were 12.3 Ncm, 12.6 Ncm, and 12.0 Ncm, respectively. 2. The mean detorque values for two screw tightening methods were 12.0 Ncm, and 12.2 Ncm, respectively. 3. The mean of mimimum detorque values for three screw tightening sequences and for two tightening methods were 10.6 Ncm, 11.1 Ncm, 10.5 Ncm, and 9.8 Ncm, respectively. 4. No statistically significant differences among the variables of screw tightening sequence and tightening method were found (p>.05) for detorque values and for mimimum detorque values. Conclusion: Within the limitations of this study, the screw tightening sequence and tightening method did not have a significant effect on the detorque values for a well-fitting implant superstructure.