The effect of screw taper on interference fit during load to failure at the soft tissue/bone interface

Can the body slope of interference screw affect initial stability of reconstructed anterior cruciate ligament?: An in-vitro investigation

Background

Superior biomechanical performance of tapered interference screws, compared with non-tapered screws, with reference to the anterior cruciate ligament (ACL) reconstruction process, has been reported in the literature. However, the effect of tapered interference screw’s body slope on the initial stability of ACL is poorly understood. Thus, the main goal of this study was to investigate the effect of the interference screw’s body slope on the initial stability of the reconstructed ACL.

Methods

Based on the best screw-bone tunnel diameter ratios in non-tapered screws, two different tapered interference screws were designed and fabricated. The diameters of both screws were equal to bone tunnel diameter in one-third of their length from screw tip, then they were gradually increased by 1mm, in the lower slope (LSTIS), and 2 mm, in the higher slope (HSTIS) screws. To simulate the ACL reconstruction, sixteen soft tissue grafts were fixed, using HSTIS and LSTIS, in synthetic bone blocks. Through applying sub-failure cyclic incremental tensile load, graft-bone-screw construct’s stiffness and graft laxity in each cycle, also through applying subsequent step of loading graft to the failure, maximum load to failure, and graft’s mode of failure were determined. Accordingly, the performance of the fabricated interference screws was compared with each other.

Results

HSTIS provides a greater graft-bone-screw construct stiffness, and a lower graft laxity, compared to LSTIS. Moreover, transverse rupture of graft fibers for LSTIS, and necking of graft in the HSTIS group were the major types of grafts’ failure.

Conclusions

HSTIS better replicates the intact ACL’s behavior, compared to LSTIS, by causing less damage in graft’s fibers; reducing graft laxity; and increasing fixation stability. Nonetheless, finding the optimal slope remains as an unknown and can be the subject of future studies.

Evaluation of the effects of different surface configurations on stability of miniscrews

Introduction. The aim of this study was to analyze the effects of screw design and force application on the stability of miniscrews, using RTT, SEM, and histomorphometric analyses. Materials and Methods. Eighty cylindrical, self-drilling, and Ti6Al4V alloy miniscrews (1,6 × 6 mm) were used. Four mini-screws were inserted in fibulas of each rabbit, and 115 G of force was immediately applied. Four miniscrews were inserted in the other fibula, on which no force was applied. Eight weeks after insertion, osseointegration between miniscrew and the surrounding bone was evaluated by the histomorphometric analyses, SEM, and RTT. Kruskal-Wallis and the paired t-tests were used for statistical analysis. Results. Values obtained from Group I were significantly higher than those of the other loaded groups (P < .05). There were no differences in RTT scores among Groups II, III, and IV. Similar findings were also observed for unloaded mini-screws. There was no significant difference between Groups I and I_C, while the differences between loaded and unloaded controls for each miniscrew were statistically significant. Conclusions. Immediate loading of miniscrews does not impair screw stability. Also, the diameter of miniscrew and more frequent thread pitches have a positive effect on stability; however, length of miniscrews does not have a significant effect on the stability.

Mechanical Characteristics of Various Orthodontic Mini-screws in Relation to Artificial Cortical Bone Thickness

Objective: To evaluate the effect of cortical bone thickness on the maximum insertion and removal torque of different types of self-drilling mini-screws and to determine if torque depends on the screw design.

Materials and Methods: Three different types of self-drilling mini-screws (cylindrical type [Cl], taper type [Ta], taper type [Tb]) were inserted with the use of a driving torque tester at a constant speed of 3 rotations per minute. Experimental bone blocks with different cortical bone thicknesses were used as specimens.

Results: Differences in the cortical bone thickness had little effect on the maximum insertion and removal torque in Cl. However, with Ta and Tb, the maximum insertion torque increased as the cortical bone thickness increased. The maximum insertion torque of Tb was highest in all situations, followed by Ta and Tb, in that order. Cl showed less torque loss in all cortical bone thicknesses and a longer removal time compared to Ta or Tb. There were significant relationships between cortical bone thickness, maximum insertion and removal torque, and implantation time in each type of self-drilling mini-screw.

Conclusion: Since different screw designs showed different insertion torques with increases in cortical bone thickness, the suitable screw design should be selected according to the cortical thickness at the implant site.