• The Journal of Advanced Prosthodontics
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• 제6권5호
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• pp.325-332
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• 2014

PURPOSE. The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS. A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS. Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION. For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva level. It is also suggested that prosthetic evaluation criteria include loose matrix, female detachment, denture fracture, denture relining, abutment fracture, abutment screw loosening, and occlusal adjustment. Finally standardized criteria like OHIP-EDENT or VAS are required for patient satisfaction.

• 대한치과보철학회지
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• 제39권3호
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• pp.297-305
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• 2001

Statement of problem. There have been previous studies about instability according to screw material by means of calculating preload in tightening screw or recording of the torque necessary to loosen screw after tightening screw. Purpose. The purpose of this study was to evaluate screw joint stability through the analysis of fitness at the mating thread surfaces between implant and screw after tightening screws made of different materials. Material and methods. In this study, screws were respectively used to secure a cemented abutment to a hexlock implant fixture; teflon coated titanium alloy screw and titanium alloy screw(Steri-Oss), gold-plated gold-palladium alloy screw and titanium alloy screw(Implant Innovation), gold screw and titanium screw(AVANA Dental Implant System). Each abutment screw was secured to the implant with recommended torque value using a digital torque controller. Each screw was again tightened after 10minutes. All samples were cross sectioned with sandpaper and polished. Then samples were evaluated with an scanning electron microscope analysis. Results. In titanium alloy screw, irregular contact and relatively large gap was present at mating thread surface. Also in teflon-coated titanium screw, incomplete seating and only partially contact was present at the mating thread surface. In gold-plated gold-palladium alloy screw, relatively close and tight contact without the presence of large gap was present by existing of gold coating at the mating thread surfaces. In gold alloy screw, relatively small gap between the mating components was seen. Conclusions. This result suggested that gold plated gold-palladium alloy screw and gold alloy screw achieved a greater degree of contact at the mating thread surfaces compared to titanium alloy screw and teflon-coated titanium alloy screw.

• 구강회복응용과학지
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• 제31권4호
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• pp.310-315
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• 2015

목적: 본 연구는 토크 게이지를 이용하여, 치과 기공사들이 임플란트 기공을 진행할 때 가하는 토크의 양을 측정해 분석하고, 이러한 결과가 보철물에 어떠한 결과를 미치는 알아보기 위함이다. 연구 재료 및 방법: 치과 기공사들이 임플란트 기공시 임플란트 나사에 가하는 토크를 디지털 토크 게이지를 이용하여 측정한다. 이후 기성지대주와 analog를 이용하여, 제조사의 권장 토크로 조였을 때의 길이를 통계학적으로 비교 분석하였다. 결과: 치과 기공사들의 임플란트 기공시 평균 토크는 $1.563{\pm}0.332Ncm$로 나타났으며, 제조사의 권장토크 값으로 조였을 때와 비교하면, 외부연결형의 침하량 차이는 없으나, 내부연결형의 침하량의 차이는 통계적으로 유의한 차이를 보였다(P < 0.05). 결론: 치과기공실에서도 제조사의 권장토크를 이용하여 보철물 기공작업을 시행하고, 정확한 토크 게이지의 사용법을 익히면, 기공오차에 따른 임플란트의 부적합을 어느 정도 해소할 수 있을 것이라 사료된다.

• 대한치과보철학회지
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• 제42권6호
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• pp.628-640
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• 2004

Statement of problem. Wear as a result of repeated closing/opening cycles may decrease the friction coefficient of screw head, threads, and other mating components and, consequently, resistance to opening gradually decreases. It may cause screw loosening, which is one of the most common failures in implant prosthesis. Purpose. The purpose of this study is to evaluate the changes on the head and thread surface of the abutment screws after repeated closing and opening through the examination of tested screws in SEM(scanning electron microscope). Materials and methods. Five species of abutments were selected (3i-three, Avana-two) respectively by two pieces. The implant fixtures were perpendicularly mounted in liquid unsaturated polyesther(Epovia, Cray Valley Inc.) with dental surveyor. Each abutment was secured to the implant fixture by each abutment screw with recommended torque value using a digital torque controller. The abutment screws were repeatedly tightened and removed 20 times with a digital controller. FESEM (field emission scanning electron microscope, Netherland, Phillips co., model:XL 30 SFEG) was used to observe changes of each part caused by repeatedly closing/opening expeiment. First, the Photomicrographs of pre-test screws provided by each manufacturer were taken. The changes of each screw were investigated after every fifth closing and opening experiment with FESEM. Scaning electron microscope photomicrographs of each screw were taken four times. Results. As the number of closing and opening was increased, the wear or distortion of hexed or squared slot that contacted with the driver tip was more severely progressed. Wear or distortion of hexed slot was more severe than that of squared slot and it was more remarkable in the titanium screw than in the gold screw. All the tested screws showed that the width in the crest of their screw thread decreased gradually as the test was proceeded. Conclusions. Conclusively, we recommend the clinical use of gold screw, a periodic exchanges of abutment screws and avoiding repeated closing/opening unnecessarily. We also suggest a more careful manipulation of the abutment screw and screw-driver and using of abutment screw with an acute-angled slot design rather than an obtuse-angled one. Finally, it is suggested that the new slot design and the surface treatment for enduring wear or distortion should be devised.

• The Journal of Advanced Prosthodontics
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• 제13권1호
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• pp.65-70
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• 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.

• 대한치과보철학회지
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• 제41권4호
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• pp.519-531
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• 2003

Statement of problem : Chronic implant screw loosening remains a problem in restorative practices. Some implant manufactureres have introduced abutment screws with treated material, surfaces and macrostructures in an effort to reduce potential loosening. Purpose : This study evaluated the materials and loading cycles on detorque value after dynamic continous fatigue test in the sinulated conditions of posterior single restoration. Material and method : Fourteen of each of the following abutment screws - titanium alloy, gold alloy, gold-tite, and titanium alloy modified - were used in test. SEM is used to verify macrostructures of each screws. $ZrO_2/Al_2O_3$ composite abutment was tightened on $4{\times}10.0mm$ titanium external implant at 30 Ncm. Cyclic loading machine delivered dynamic loading forces between 20 and 320N for 100,000, 200,000, 300,000, 500,000, and 1,000,000 cycles at frequencies 14Hz. Torque and detorque value after loading was measured. Results : All measued screws had different screw length and thread form. Titanium modified screw had greater detorque value than others before and after cyclic loadings(p<0.05). All abutment screws had no significant change in mean percentage of detorque value after loading to initial value after less than 500.000 cyclic loadings, but significant lower value after 1,000,000 cycles(p<0.05). Conclusion : Within limintations of this study all abutment screws may be loosend after about 1 year use. Annual check-up is nessasary to prevent screw loosening.

• The Journal of Advanced Prosthodontics
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• 제8권1호
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• pp.62-69
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• 2016

PURPOSE. The purpose of this study was to evaluate the effects of abutment screw length and cyclic loading on the removal torque (RTV) in external hex (EH) and internal hex (IH) implants. MATERIALS AND METHODS. Forty screw-retained single crowns were connected to external and internal hex implants. The prepared titanium abutment screws were classified into 8 groups based on the number of threads (n = 5 per group): EH 12.5, 6.5, 3.5, 2.5 and IH 6.5, 5, 3.5, 2.5 threads. The abutment screws were tightened with 20 Ncm torque twice with 10-minute intervals. After 5 minutes, the initial RTVs of the abutment screws were measured with a digital torque gauge (MGT12). A customized jig was constructed to apply a load along the implant long axis at the central fossa of the maxillary first molar. The post-loading RTVs were measured after 16,000 cycles of mechanical loading with 50 N at a 1-Hz frequency. Statistical analysis included one-way analysis of variance and paired t-tests. RESULTS. The post-loading RTVs were significantly lower than the initial RTVs in the EH 2.5 thread and IH 2.5 thread groups (P<.05). The initial RTVs exhibited no significant differences among the 8 groups, whereas the post-loading RTVs of the EH 6.5 and EH 3.5 thread groups were higher than those of the IH 3.5 thread group (P<.05). CONCLUSION. Within the limitations of this study, the external hex implants with short screw lengths were more advantageous than internal hex implants with short screw lengths in torque maintenance after cyclic loading.

• 대한치과기공학회지
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• 제26권1호
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• pp.69-76
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• 2004

The objective of this finite element method study was to analyze the stress distribution induced on a supporting bone by 3.75mm, 4.0mm, 5.0mm diameter of dental implant fixture(13mm length). 3-dimensional finite element models of simplified gold alloy crown(7mm height) and dental implant structures(gold cylinder screw, gold cylinder, abutment screw, abutment, fixture and supporting bone(cortical bone, cancellous bone) designs were subjected to a simulated biting force of 100 N which was forced over occlusal plane of gold alloy crown vertically. Maximum von Mises stresses(MPa) under vertical loading were 9.693(3.75mm diameter of fixture), 8.885(4.0mm diameter of fixture), 6.301(5.0mm diameter of fixture) and the highest von Mises stresses of all models were concentrated in the surrounding crestal cortical bone. The wide diameter implant was the good choice for minimizing cortical bone-fixture interface stress.

• The Journal of Advanced Prosthodontics
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• 제7권2호
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• pp.160-165
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• 2015

PURPOSE. In this study, a temporal abutment fixation screw, designed to fracture in a controlled way upon application of an occlusal force sufficient to produce critical micromotion was developed. The purpose of the screw was to protect the osseointegration of immediate loaded single implants. MATERIALS AND METHODS. Seven different screw prototypes were examined by fixing titanium abutments to 112 Mozo-Grau external hexagon implants (MG Osseous$^{(R)}$; Mozo-Grau, S.A., Valladolid, Spain). Fracture strength was tested at $30^{\circ}$ in two subgroups per screw: one under dynamic loading and the other without prior dynamic loading. Dynamic loading was performed in a single-axis chewing simulator using 150,000 load cycles at 50 N. After normal distribution of obtained data was verified by Kolmogorov-Smirnov test, fracture resistance between samples submitted and not submitted to dynamic loading was compared by the use of Student's t-test. Comparison of fracture resistance among different screw designs was performed by the use of one-way analysis of variance. Confidence interval was set at 95%. RESULTS. Fractures occurred in all screws, allowing easy retrieval. Screw Prototypes 2, 5 and 6 failed during dynamic loading and exhibited statistically significant differences from the other prototypes. CONCLUSION. Prototypes 2, 5 and 6 may offer a useful protective mechanism during occlusal overload in immediate loaded implants.

• Journal of Periodontal and Implant Science
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• 제52권6호
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• pp.496-508
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• 2022

Purpose: This study aimed to compare the long-term survival rate and peri-implant marginal bone loss between different types of dental implant-abutment connections. Methods: Implants with external or internal abutment connections, which were fitted at Gangneung-Wonju National University Dental Hospital from November 2011 to December 2015 and followed up for >5 years, were retrospectively investigated. Cumulative survival rates were evaluated for >5 years, and peri-implant marginal bone loss was evaluated at 1- and 5-year follow-up examinations after functional loading. Results: The 8-year cumulative survival rates were 93.3% and 90.7% in the external and internal connection types, respectively (P=0.353). The mean values of marginal bone loss were 1.23 mm (external) and 0.72 mm (internal) (P<0.001) after 1 year of loading, and 1.20 mm and 1.00 mm for external and internal abutment connections, respectively (P=0.137) after 5 years. Implant length (longer, P=0.018), smoking status (heavy, P=0.001), and prosthetic type (bridge, P=0.004) were associated with significantly greater marginal bone loss, and the use of screw-cement-retained prosthesis was significantly associated (P=0.027) with less marginal bone loss. Conclusions: There was no significant difference in the cumulative survival rate between implants with external and internal abutment connections. After 1 year of loading, marginal bone loss was greater around the implants with an external abutment connection. However, no significant difference between the external and internal connection groups was found after 5 years. Both types of abutment connections are viable treatment options for the reconstruction of partially edentulous ridges.