• The Journal of Korean Academy of Prosthodontics
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• v.35 no.4
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• pp.767-780
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• 1997

One of the most common problems of implant prosthesis is the screw loosening of abutment screws. This brings on discomfort in mastication, inflammation in the peri-implant tissue due to poor oral hygiene and fracture of prosthesis or loss of osseointegration. To prevent screw loosening, appropriate implantation to direct the occlusal force to the long axis of the implant, accurate design of the superstructure, decrease of the occlusal table, and adequate torque on the abutment screw are necessary. In this study the screw loosening torque was evaluated in implants with dimples or flutes in the internal surface of abutment screw holes. The abutments were fastened with slot type and hexagonal type abutment screws and were sealed with vinyl poly siloxane impression and bite registration material respectively. The screw loosening torque was evaluated after 1,800 and 12,600 times loading under a loading machine. The results were as follows. 1. The flute form group showed significantly higher loosening torque compared to the dimple form group and the group with no inner surface treatment (p<0.05). 2. There was no statistical difference in loosening torque according to the sealing materials. 3. The loosening torque according to the types of abutment screw showed no significant difference. 4. The loosening torque was significantly higher after 1800 times loading compared to 12600 times loading(p<0.05). From the above results. it is thought that formation of a flute in the internal surface of the screw hole decreases the chance of screw loosening, but the sealing materials and types of abutment screw did not show significant difference in prevention of screw loosening.

• 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.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.1
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• pp.60-66
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• 2015

Screw loosening and screw fracture of abutment is one of most frequent mechanical complications in implant restoration. Fractured fragments in implant restoration like abutment and screw should be completely removed and the procedure needs minimal damage to the fixture of implant. In some cases, it could fail to remove fractured fragments and cause a lot of damage to the fixture of implant. These situations could render implant unusable at the worst. This article describes three different situations and simple techniques for successful removal of fractured fragments without damage of implants. The procedures used are described in this clinical report.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.2
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• pp.174-184
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• 2006

Purpose: Current trend in implant dentistry is changing from external connection to internal connection. To evaluate the splinting of external and internal connection implant on screw loosening, 2-units prosthesis was fabricated with BioPlant $System^(R)$ of external connection type and Lifecore STAGE-1 Single Stage Implant $System^(R)$ of internal connection type. Material and Method: Experimental group is classified into three groups. 1) $G_1-EE$: 2-units prosthesis was fabricated with two Bioplant $System^(R)$ of external connection type. 2) $G_1-EI$: 2-units prosthesis was fabricated with one BioPlant $System^(R)$ of external connection type and one Lifecore STAGE-1 Single Stage Implant $System^(R)$ of internal connection type. 3) $G_1-II$: 2-units prosthesis was fabricated with two Lifecore STAGE-1 Single Stage Implant $System^(R)$ of internal connection type. In fabricating 2-units prosthesis, two hexed abutments are recommended when two implants are installed parallel, otherwise one hexed abutment is used on major occlusal force area and one nonhexed abutment is used on the other area. Since it is rare to find two implants being parallel, it is hard to fabricate prosthesis with passive adaptation using two hexed abutments. It is much more difficult to acquire passive adaptation when using hex abutment compared to nonhex abutment. To evaluate the influence of hexed and nonhexed abutment on screw loosening, 2-units prosthesis was fabricated with hexed and nonhexed abutment. Experimental group is classified into three groups. 1) $G_2-HH$: 2-units prosthesis was fabricated with two hexed abutments. 2) $G_2-HN$: 2-units prosthesis was fabricated with one hexed abutment and one nonhexed abutment. 3) $G_2-NN$: 2-units prosthesis was fabricated with two nonhexed abutments. Result: The results of comparing the detorque value after loading on a each prosthesis periodically are as follows. 1. In splinting group of external and internal connection implant, $G_1-II$ group demonstrated the biggest detorque value, followed by $G_1-EI$ group and $G_1-EE$ group. 2. There is no notable significance between external connection implant of $G_1-EI$ group and $G_1-EE$ group and also no significance between internal connection implant of $G_1-EI$ group and $G_1-II$ group. 3. $G_2-HH$ group showed higher detorque value than $G_2-HN\;and\;G_2-NN$ group. From the results, we can concluded that using both external connection and internal connection implant together is clinically acceptable and in order to acquire a good passive adaptation in fabricating 2-units implant prosthesis we can use two nonhexed abutments.

• The Journal of Korean Academy of Prosthodontics
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• v.42 no.2
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• pp.192-209
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• 2004

Purpose : The purpose of this study was to evaluate the machining accuracy and consistency of implant/abutment/screw combination or internal connection type. Material and methods: In this study, each two randomly selected internal implant fixtures from ITI, 3i, Avana, Bicon, Friadent, Astra, and Paragon system were used. Each abutment was connected to the implant with 32Ncm torque value using a digital torque controller or tapping. All samples were cross-sectioned with grinder-polisher unit (Omnilap 2000 SBT Inc) after embeded in liquid unsaturated polyester (Epovia, Cray Valley Inc). Then optical microscopic and scanning electron microscopic(SEM) evaluations of the implant-abutment interfaces were conducted to assess quality of fit between the mating components. Results : 1) Generally, the geometry of the internal connection system provided for a precision fit of the implant/abutment into interface. 2) The most precision fit of the implant/abutment interface was provided in the case of Bicon System which has not screw. 3) The fit of the implant/abutment interface was usually good in the case of ITI, 3I and Avana system and the amount of fit of the implant/abutment interface was similar to each other. 4) The fit of the implant/abutment interface was usually good in the case of Friadent, Astra and Paragon system. The case of Astra system with the inclined contacting surface had the most Intimate contact among them. 5) Amount of intimate contact in the abutment screw thread to the mating fixture was larger in assembly with two-piece type which is separated screw from abutment such as Friadent, Astra and Paragon system than in that with one-piece type which is not seperated screw from abutment such as ITI, 3I and Avana system. 6) Amount of contact in the screw and the screw seat of abutment was larger in assembly of Friadent system than in asembly of Astra system of Paragon system. Conclusion: Although a little variation in machining accuracy and consistency was noted in the samples, important features of all internal connection systems were the deep, internal implant-abutment connections which provides intimate contact with the implant walls to resist micro-movement, resulting in a strong stable interface. From the results of this study, further research of the stress distribution according to the design of internal connection system will be required.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.2
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• pp.137-147
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• 2008

Statement of problem: Dental implant procedure has been recognized as a very effective treatment to rehabilitate fully or partially edentulous patients. However, mechanical failures such as screw loosening, screw fracture have been still reported frequently. Purpose: The purpose of this study was to evaluate the influence of tungsten carbide/carbon coating, which has superior hardness and frictional wear resistance, on implant-abutment screw loosening of three different joint connections after one million cyclic loading. Material and methods: The values of detorque before and after loading were measured in three different joint connections (Osstem Implant, Korea), one external butt joint, US II implant system and two internal cones, SS II and GS II system. The values of detorque before loading was analyzed by one-way ANOVA, and two-way ANOVA and Scheffe' test were performed for the value of detorque after loading. Results: 1. The values of initial detorque of tungsten carbide/carbon coated Ti alloy screw were smaller those of Ti alloy screw (P<.01), and there were no differences among implant systems in each screw (P>.05). 2. In comparison of loss rate of detorque value after cyclic loading, US II system was greater than SS II and GS II system but there was no difference between SS II and GS II system (P<.01). 3. Loss rates of detorque value after cyclic loading decreased consistently at tungsten carbide/carbon coated Ti alloy screw comparing with Ti alloy screw in all implant systems (P<.01), and there were no differences among three systems in reduction of loss rates by using tungsten carbide/carbon coated Ti alloy screw (P>.05). Conclusion: Tungsten carbide/carbon coating to increase preload with reduction of friction resistance was a effective way to decrease screw loosening by functional loading.

• The Journal of Korean Academy of Prosthodontics
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• v.40 no.3
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• pp.246-261
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• 2002

The screw loosening is one of the complications that happen frequently in dental implant prostheses. The purpose of this study was to evaluate the changes of reverse/loosening (opening) torque of the screw according to the surface modifications by sandblasting and 24K gold electroplating as well as to determine the possibility of the clinical use of a washer in dental implant. The reverse torque of 4 experimental conditions(control, sandblasted, use of washers, electroplasted) was measured by digital torque gauge (Model MGT50Z, Mark-10 Corp., 458 West John Street Hicksville, NY 11801 USA). Electronic torque controller (Nobel Biocare DEA 020) was used in fastening the gold screws into abutment replicas. Mixed Linear Model Analysis method was used for statistical analysis. To examine the changes of screw thread surface, microphotographs were taken by Olympus PME-3 metallurgic microscope (Olympus Optical Co. Ltd., Tokyo, Japan). Within the limitations of this study, the following results were drawn: 1. The surface modifications of the gold screws and the use of a washer have significantly affected the reverse torque value compared to the control group (P<0.01). 2. Sandblasting and electroplating treatments demonstrated significantly higher reverse torque value than that of control group. 3. The use of a washer may be one of the useful clinical methods that prevent the screw loosening. However, further studies are necessary for the material selection and design of the washer.

• Proceedings of the KSME Conference
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• 2001.11a
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• pp.406-411
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• 2001

The expandable implant employs an inner expansion screw in order to expand several legs of implant. Compressive stresses are produced at the bone tissue surrounding the implant, and the contact area between the implant and the bone tissue is increased, which result in increased resistance to horizontal and vertical pressure loads. The stress distribution in implant is also an important factor. Three types of implant models including an existing one have been investigated by using the Finite Element Method, and an improved design model has been suggested.

• The Journal of Advanced Prosthodontics
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• v.14 no.1
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• pp.22-31
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• 2022

PURPOSE. The purpose of this study was to investigate the misfit and screw preload at the implant abutment connection of implant supported fixed dental prosthesis with cantilever (ICFDP) manufactured using different digital manufacturing techniques and to compare the screw preload before and after cyclic loading. MATERIALS AND METHODS. Mandibular jaw model with four intra-foraminal implants was scanned using digital scanner. Stereolithography file was used to design a framework with nonengaging (NE) abutments and 10 mm cantilever distal to one terminal implant. Five frameworks were constructed using combined digital-conventional techniques (CAD-cast), and five frameworks were constructed using three-dimensional printing (3DP). Additional CAD-cast framework was constructed in a way that ensures passive fit (PF) to use as control. Scanning electron microscope (SEM) measured the implant abutment connection misfit. Sixty screws were used on the corresponding frameworks. Screws were torqued and pre-cyclic loading reverse torque value (RTV) was recorded. Frameworks were subjected to 200,000 loading cycles with a loading point 9 mm from the center of terminal implants adjacent to the cantilever and post-cyclic loading RTVs were recorded. RESULTS. Microscopic readings showed significant differences between frameworks. PF demonstrated the lowest measurements of 16.04 (2.6) ㎛ while CAD-cast demonstrated the highest measurements of 29.2 (3.1) ㎛. In all groups, RTVs were significantly lower than the applied torque. Post-cyclic loading RTV was significantly lower than pre-cyclic loading RTV in PF and 3DP frameworks. Differences in RTVs between the three manufacturing techniques were insignificant. CONCLUSION. Although CAD-cast and three-dimensionally printed (3DP) both produce frameworks with clinically acceptable misfit, 3DP might not be the technique of choice for maintaining screw's preload stability under an aggressive loading situation.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.4
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• pp.421-431
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• 2006

Statement of problem : Accurate impression is essential to success of implant prostheses. But there have been few studies about the accuracy of fixture-level impression technique in internal connection implant system. Purpose: This study evaluated the accuracy of splinted fixture-level impression technique using clinical methods and the effect of internal hex on fit of superstructure in internal connection implant system (Astra Tech). Material and method : Two metal master frameworks made from two abutments (Cast-to Abutment ST) each for parallel and divergent conditions and a corresponding. passively fitting, dental stone master cast with four future replicas (Fixture Replica ST) were fabricated. Ten dental stone casts were made with vinyl polysiloxane impressions from the master cast by acrylic resin splinted fixture-level impression technique. To evaluate the accuracy of impression technique, the fit of master frameworks for test models was evaluated using screw resistance test (SRT) and one-screw test. The results of SRT were recorded as SRT values from grade 1 to grade 5 by 1/4 turn. And to evaluate the effect of hex on fit of superstructure, the same tests were performed after removing hexes of master frameworks. Results: 1. There was only one case (2.5%) showing SRT value of test model below ade 2 in total before and after removing hexes of master frameworks. And, by removing hexes. SRT values decreased in only one test model (5%) and did not change in 17 test models (85%). 2. SRT values of the 1$^{st}$ screws were grade 2 in 80% of cases before, and grade 1 in 80% of cases after removing hexes. And, by removing hexes, SRT values decreased in 72.5% of cases. 3. SRT values of the 2$^{nd}$ screws were grade 3 in 85% of cases before, and grade 3 in 95% of cases after removing hexes. And, by removing hexes, SRT values did not change in 85% of cases. 4. There were only 2 cases regarded as acceptable fit by one-screw test, and SRT values of 2$^{nd}$ screws of both cases were grade 2. Conclusion. Within the limitations of this study, future-level impression of internal connection implant system is considered to obtain inaccurate working cast, even using acrylic resin splinted impression technique. And, it is considered to be unable improve the fit to remove the hexes of implant restoration.