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Tolesano Loureiro KR, Boaventura de Moura M, de Oliveira GJPL, Resende Novais V, Zancopé K, Simamoto Júnior PC. Mechanical Behavior of One-Piece and Two-Piece Tapered Prosthetic Abutments with 11.5 and 16 Degrees. Healthcare (Basel) 2023; 11:1775. [PMID: 37372893 DOI: 10.3390/healthcare11121775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/06/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
The objective of this study is to examine the mechanical behavior of two-piece abutments (Morse taper with 16° internal angulation and Morse taper with 11.5° internal angulation) before and after cyclic fatigue testing, following ISO 14801:2016 guidelines. The specimens were divided into three groups: a modified Morse taper with a taper angle of 16° (GM group), a conventional Morse taper (taper angle of 11.5° deg) with a two-piece (CMt group), and one-piece abutments (CMo group). Each experimental group was formed by ten implants and ten abutments (n = 10) for a total of 30 specimens (n = 30). The abutments were tightened and loosened, and a fatigue test was applied with 15 Hz and 5 × 106 cycles. Subsequently, the abutments were loosened, and a pull-out test was performed on the CMt group. Finite element analysis (FEA) was conducted on stress concentration regions. The statistical analysis of the loosening test was performed using two-way ANOVA and Tukey's tests (p < 0.05) to compare screw loosening within each group and between the groups with and without mechanical fatigue. Significant differences were found among the three groups in the loosening test when analyzing the values with and without fatigue (p < 0.001) within each group. When the groups were compared with each other, there was also a significant difference between them (p < 0.001), except between groups GM and CMt without fatigue (p = 0.840). In the pull-out test of the CMt group, the sample exhibited frictional locking only after fatigue (mean = 94.2 N). The FEA demonstrated a varied stress distribution in all groups. The stress was found to be more concentrated in the upper third and middle third regions of the implant, as well as in the opposite region of the load application for all three groups. Although the CMo group showed lower rates of loosening, it displayed a poorer stress distribution in comparison to the GM and CMt groups. On the other hand, the CMt group exhibited a satisfactory frictional lock after undergoing the fatigue tests.
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Affiliation(s)
- Karine Regina Tolesano Loureiro
- Department of Occlusion, Fixed Prosthodontics and Dental Materials, School of Dentistry, Federal University of Uberlandia, Uberlandia 38405-320, MG, Brazil
| | | | | | - Veridiana Resende Novais
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlandia, Uberlandia 38405-320, MG, Brazil
| | - Karla Zancopé
- Department of Occlusion, Fixed Prosthodontics and Dental Materials, School of Dentistry, Federal University of Uberlandia, Uberlandia 38405-320, MG, Brazil
| | - Paulo Cézar Simamoto Júnior
- Department of Occlusion, Fixed Prosthodontics and Dental Materials, School of Dentistry, Federal University of Uberlandia, Uberlandia 38405-320, MG, Brazil
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Zhang WT, Cheng KJ, Liu YF, Wang R, Chen YF, Ding YD, Yang F, Wang LH. Effect of the prosthetic index on stress distribution in Morse taper connection implant system and peri-implant bone: a 3D finite element analysis. BMC Oral Health 2022; 22:431. [PMID: 36180871 PMCID: PMC9523891 DOI: 10.1186/s12903-022-02465-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background The combination of a prosthetic index with Morse taper connection was developed, with the purpose of making prosthetic procedures more precise. However, the presence of the index may compromise the mechanical performance of the abutment. The aim of this study is to evaluate the effect of prosthetic index on stress distribution in implant–abutment-screw system and peri-implant bone by using the 3D finite element methodology. Methods Two commercial dental implant systems with different implant–abutment connections were used: the Morse taper connection with platform switching (MT-PS) implant system and the internal hex connection with platform matching (IH-PM) implant system. Meanwhile, there are two different designs of Morse taper connection abutment, namely, abutments with or without index. Consequently, three different models were developed and evaluated: (1) MT-PS indexed, (2) MT-PS non-indexed, and (3) IH-PM. These models were inserted into a bone block. Vertical and oblique forces of 100 N were applied to each abutment to simulate occlusal loadings. Results For the MT-PS implant system, the maximum stress was always concentrated in the abutment neck under both vertical and oblique loading. Moreover, the maximum von Mises stress in the neck of the MT-PS abutment with index even exceed the yield strength of titanium alloy under the oblique loading. For the IH-PM implant system, however, the maximum stress was always located at the implant. Additionally, the MT-PS implant system has a significantly higher stress level in the abutment neck and a lower stress level around the peri-implant bone compared to the IH-PM implant system. The combined average maximum stress from vertical and oblique loads is 2.04 times higher in the MT-PS indexed model, and 1.82 times for the MT-PS non-indexed model than that of the IH-PM model. Conclusions MT-PS with index will cause higher stress concentration on the abutment neck than that of without index, which is more prone to mechanical complications. Nevertheless, MT-PS decreases stress within cancellous bone and may contribute to limiting crestal bone resorption.
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Affiliation(s)
- Wen-Tao Zhang
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No. 158 Shangtang Rd., Hangzhou, 310014, China
| | - Kang-Jie Cheng
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, 310023, China.,Key Laboratory of Special Purpose Equipment and Advanced Processing Technology, Ministry of Education and Zhejiang Province, Zhejiang University of Technology, Hangzhou, 310023, China.,National International Joint Research Center of Special Purpose Equipment and Advanced Processing Technology, Zhejiang University of Technology, Hangzhou, 310023, China
| | - Yun-Feng Liu
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, 310023, China.,Key Laboratory of Special Purpose Equipment and Advanced Processing Technology, Ministry of Education and Zhejiang Province, Zhejiang University of Technology, Hangzhou, 310023, China.,National International Joint Research Center of Special Purpose Equipment and Advanced Processing Technology, Zhejiang University of Technology, Hangzhou, 310023, China
| | - Russell Wang
- Department of Comprehensive Care, Case Western Reserve University School of Dental Medicine, Cleveland, OH, 44106-4905, USA
| | - Yun-Fang Chen
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No. 158 Shangtang Rd., Hangzhou, 310014, China
| | - Yu-de Ding
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No. 158 Shangtang Rd., Hangzhou, 310014, China
| | - Fan Yang
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No. 158 Shangtang Rd., Hangzhou, 310014, China.
| | - Lin-Hong Wang
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No. 158 Shangtang Rd., Hangzhou, 310014, China.
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dos Santos AMT, Stabile GAV, Felizardo KR, dos Santos SER, Berger SB, Guiraldo RD, Gonini AG, Lopes MB. Evaluation of Removal Force in Prosthetic Components of Morse Taper Dental Implants. Braz Dent J 2022; 33:74-80. [PMID: 36287501 PMCID: PMC9645169 DOI: 10.1590/0103-6440202205084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 07/28/2022] [Indexed: 06/16/2023] Open
Abstract
The longevity of prosthetic rehabilitation is determined by the stability of the implant and abutment interfaces. True morse taper connections on dental restorations have been effective, however activation force still empirical. This work compared the activation strength and internal contact of Morse taper system according to the removal force. Eighty sets, composed of implants and prosthetic abutments, were evaluated with different internal contact areas; 15.12mm2 (G3.3) and 21.25mm2 (G4.3). The specimens were activated at 0° and 30°, with loads of 10, 20, 40 and 60N. The specimens were submitted to tensile test and the data to ANOVA and Tukey's tests (α=0.05). Representative specimens were examined under SEM. Removal force of G3.3 (2.15±1.33MPa) did not differed to G4.3 (1.99±1.03MPa). The activation at 0º (2.95±0.98MPa) statistically differed to 30º (1.19±0.54MPa). The 60N load was statistically superior for G3.3 and there was no statistical difference between 20N to 60N in G4.3. The values of 10N at 30o and 20N at the long axis of the morse taper implant, independent of the frictional contact area showed the best settlement.
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Affiliation(s)
| | | | | | | | | | | | - Alcides Gonini Gonini
- Department of Restorative Dentistry, State University of Londrina, Londrina, PR, Brazil
| | - Murilo Baena Lopes
- Department of Restorative Dentistry, University North of Parana, Londrina, PR, Brazil
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The Mechanical Behavior of a Screwless Morse Taper Implant-Abutment Connection: An In Vitro Study. MATERIALS 2022; 15:ma15093381. [PMID: 35591715 PMCID: PMC9103680 DOI: 10.3390/ma15093381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/19/2022] [Accepted: 05/04/2022] [Indexed: 12/13/2022]
Abstract
The use of screwless Morse taper implant−abutment connections (IAC) might facilitate the clinician’s work by eliminating the mechanical complications associated with the retention screw. The aim of this study is to evaluate the effect of artificial chewing on the long-term stability of screwless Morse taper IACs. Thirty-two implant abutments restored with an upper central incisor zirconia crown were used and divided into four groups according to the implant−abutment assembling manner (C1,H: screw retained (20 Ncm); C2: tapped; or C3: torqued (20 Ncm; the screws were removed before the dynamic loading)). All specimens were subjected to a cyclic loading (98 N) for 10 million chewing cycles. The survived samples were exposed to a pull-off force until failure/disassembling of the connection. All the samples revealed a 100% survival. Regarding the pull-off test, the screw-retained internal hexagonal IAC revealed significantly higher resistance to failure/disassembling (769.6 N) than screwless conical IACs (171.6 N−246 N) (p < 0.0001). The retention forces in the Morse taper groups were not significantly different (p > 0.05). The screw-retained hexagonal IAC showed the highest retention stability. The screw preload/retention in the conical IAC was lost over time in the group where the screws were kept in place during loading. Nevertheless, the screwless Morse taper IACs were stable for an extended service time and might represent a valid form of treatment for single-tooth replacement.
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Jin X, Guan Y, Ren J, Zhao Y, Wang X, He F. A retrospective study of 12,538 internal conical connection implants: focused on the long-term integrity of implant-abutment complexes. Clin Oral Implants Res 2022; 33:377-390. [PMID: 35113487 DOI: 10.1111/clr.13898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 12/29/2021] [Accepted: 01/24/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To evaluate the long-term integrity of implant-abutment complexes in implant systems with two internal conical angles. MATERIAL AND METHODS 12,538 bone-level implants of two systems placed between January 2012 and December 2018 were retrospectively analyzed. Cumulative abutment/implant fracture rates in systems with larger (LA, 7.5°) and smaller (SA, 5.7°) internal conical angles were estimated using Kaplan-Meier analysis and compared between groups. The association between implant systems and jammed abutment retrievability was evaluated by multivariable generalized estimating equation logistic regression modelling. RESULTS For LA, the 8-year cumulative incident rate was 0.10% (95% confidence interval (CI): 0-0.24%) for implant fracture and 0.26% (95% CI: 0.11%-0.41%) for abutment fracture, demonstrating a significant difference in gender (p = 0.03), implant diameter (p = 0.01), jaw (p = 0.006) and antagonist tooth (p < 0.001). For SA, the 8-year cumulative incident rate was 0.38% (95% CI: 0-0.79%) for implant fracture and 2.62% (95% CI: 0.05%-5.13%) for abutment fracture, which was influenced by implant diameter (p < 0.001) and site (p = 0.03). The cumulative implant/abutment fracture rate was lower for LA implants, particularly for LA implant-supported single crowns (SCs) (p < 0.05). The abutment-retrieval success rate was 92.8% for LA, and 57.1% for SA (p = 0.055). CONCLUSION LA implants exhibited a lower incidence of fracture in abutment-implant complexes and a relatively higher retrievability success rate for jammed abutments.
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Affiliation(s)
- Xiaoting Jin
- Department of Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Ye Guan
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Jie Ren
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Yanwei Zhao
- School of Materials Science and Engineering, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaoxiang Wang
- School of Materials Science and Engineering, Zhejiang University, Hangzhou, Zhejiang, China
| | - Fuming He
- Department of Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
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Ozdiler A, Dayan SC, Gencel B, Ozkol GI. Reverse Torque Values of Abutment Screws After Dynamic Loading: Effects of Sealant Agents and the Taper of Conical Connections. J ORAL IMPLANTOL 2021; 47:287-293. [PMID: 32870274 DOI: 10.1563/aaid-joi-d-19-00228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this in vitro study was to evaluate the influence of taper angle in internal conical connections of implant systems and the application of chlorhexidine gel as an antibacterial agent or polyvinyl siloxane sealant on reverse torque values of abutment screws after dynamic loading. Four implant systems having different taper angles (5.4°, 12°, 45°, 60°) were tested in this study. Test specimens were divided into 3 groups: control (neither chlorhexidine gel filled nor silicone sealed), 2% chlorhexidine gel filled, and silicone sealed. The samples were subjected to a dynamic load of 50 N at 1 Hz for 500 000 cycles before reverse torque measurements. The taper angle of conical connections presented a quantitative positive correlation between the degree of the taper angle and the percentage of tightening torque loss. However, it was significant only between 60° angled connection and others except for the sealant applied groups (P = .013 for control groups and P = .007 for chlorhexidine groups). The percentages of decrease in torque values of silicon sealant-applied specimens were significantly higher than both the control and chlorhexidine groups (P values are .001, .002, .001, and .002, respectively, according to increasing taper angles), but the percentage of decrease in torque values due to chlorhexidine application was not statistically significant when compared with control groups. Gel form chlorhexidine application as an antibacterial agent does not significantly affect the implant-abutment connection stability under dynamic loads. Polyvinyl siloxane sealant may cause screw loosening under functional loads.
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Affiliation(s)
- Arda Ozdiler
- Department of Prosthodontics, Istanbul University, Faculty of Dentistry Istanbul, Turkey
| | | | - Burc Gencel
- Program of Dental Technicians, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Gulbahar Isık Ozkol
- Department of Prosthodontics, Istanbul University, Faculty of Dentistry Istanbul, Turkey
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Alevizakos V, Mosch R, Mitov G, Othman A, von See C. Pull-off resistance of a screwless implant-abutment connection and surface evaluation after cyclic loading. J Adv Prosthodont 2021; 13:152-159. [PMID: 34234925 PMCID: PMC8250190 DOI: 10.4047/jap.2021.13.3.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 04/20/2021] [Accepted: 05/28/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The aim of this study was to investigate to what extent cyclic load affects the screwless implant-abutment connection for Morse taper dental implants. MATERIALS AND METHODS 16 implants (SICvantage max) and 16 abutments (Swiss Cross) were used. The screwless implant-abutment connection was subjected to 10,000 cycles of axial loading with a maximum force of 120 N. For the pull-off testing, before and after the same cyclic loading, the required force for disconnecting the remaining 6 implant-abutment connections was measured. The surface of 10 abutments was examined using a scanning electron microscope 120× before and after loading. RESULTS The pull-off test showed a significant decrease in the vertical force required to pull the abutment from the implant with mean 229.39 N ± 18.23 before loading, and 204.30 N ± 13.51 after loading (P<.01). Apart from the appearance of polished surface areas and slight signs of wear, no visible damages were found on the abutments. CONCLUSION The deformation on the polished abutment surface might represent the result of micro movements within the implant-abutment connection during loading. Although there was a decrease of the pull-off force values after cyclic loading, this might not have a notable effect on the clinical performance.
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Affiliation(s)
- Vasilios Alevizakos
- Department of CAD/CAM and Digital Technologies in Dentistry, Danube Private University, Krems, Austria
| | - Richard Mosch
- Department of CAD/CAM and Digital Technologies in Dentistry, Danube Private University, Krems, Austria
| | - Gergo Mitov
- Department of Prosthodontics and Biomaterials, Danube Private University, Krems, Austria
| | - Ahmed Othman
- Department of CAD/CAM and Digital Technologies in Dentistry, Danube Private University, Krems, Austria
| | - Constantin von See
- Department of CAD/CAM and Digital Technologies in Dentistry, Danube Private University, Krems, Austria
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Rezayani V, Alikhasi M, Monzavi A. Effect of Serrating Abutment-Implant Mating Surface on Torque Stability of Implant-Abutment Connection, Before and After Cyclic Loading. J ORAL IMPLANTOL 2020; 46:555-561. [PMID: 33494101 DOI: 10.1563/aaid-joi-d-19-00029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study evaluated the effect of adding serration to the abutment-implant connection on torque maintenance before and after loading. Two implant systems with the same dimensions and connection design (internal 8° Morse taper octagon) were selected: one with nonserrated abutments (Simple line II) and the other one with serrated abutments (F & B). The removal torque value (RTV) was measured in 2 groups for each system: one group with one-piece abutments and the other group with 2-piece abutments, before and after cyclic loading (n = 10 in each group). The initial RTV of the abutment screw was measured with a digital torque meter. Each abutment received a cement-retained metal crown with 30° occlusal surface. Cyclic axial peak load of 75 ± 5 N was applied to the implants for 500 000 cycles at 1 Hz. The post-load RTV was then measured. Two-way and repeated-measures analysis of variance (ANOVA), and independent t test were applied to assess the effects of cyclic loading, connection design, abutment type, and their interaction on the percentage of torque loss (α = .05). Two-way ANOVA showed that serration of mating surfaces had a significant effect on torque maintenance before (P < .001) and after (P = .004) cyclic loading. Repeated-measures ANOVA also showed that loading had a significant effect on the torque loss percentage (P < .01). Comparison of the groups with t test showed that the torque loss of the serrated groups was lower than that of non- serrated groups. Despite the limitations of this study, the stability of the implant-abutment connection in the serrated design was higher than that of non-serrated group.
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Affiliation(s)
- Vida Rezayani
- Assistant Professor, Department of Prosthodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieh Alikhasi
- Associate Professor, Dental Research Center, Implant Research Center, Laser Research Center, Dentistry Research Institute, Tehran University of Medical Sciences and Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Monzavi
- Professor, Department of Prosthodontics and Implant, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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de Moura MB, Loureiro KRT, Lima LB, Felippi C, Júnior PCS. Biomechanical behavior of three different types of internal tapered connections after cyclic and static loading tests: experimental in vitro. Int J Implant Dent 2020; 6:41. [PMID: 32696277 PMCID: PMC7374674 DOI: 10.1186/s40729-020-00228-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 05/25/2020] [Indexed: 11/10/2022] Open
Abstract
Abstract Background In the long-term success of a dental implant, the reliability and stability of the implant-abutment interface are important. Studies of maximum force of dental implants with different loading values have been used. This study aims to evaluate the influence of the oblique cyclic loading on the maximum force supported in one-piece and two-piece abutments installed on internal tapered implants. Findings Sixty implants and sixty prosthetic abutments were divided into six groups (n = 10): G1 and G2 (two-piece abutments with 16°), G3 and G4 (two-piece abutments with 11.5°), and G5 and G6 (one-piece abutments with 11.5°). A 2-Hz cyclic loading was applied to specimens of G2, G4, and G6, with a number of cycles of 2,400,000. All specimens were inclined by 30° from the vertical axis, and a vertical loading was applied over the tapered connections (ISO 14801). Then, the maximum force was tested by applying a static compression load on the specimens of the 6 groups tested (30°) at a rate of 0.5 mm/s. Statistical analysis was performed using the Shapiro-Wilk (p > 0.05) and Levene (p = 0.789) tests to determine if the data presented homoscedasticity and the Tukey test for multiple comparisons. Tukey test showed that the maximum force supported by G1 and G2 was not affected by the cyclic load, while in G3 and G4 it decreased significantly when subjected to the cyclic load. The G5 and G6 had a significant increase in maximum force supported when subjected to cyclic load. Conclusions Cyclic loading influenced the maximum force supported of G4 and G6 but did not influence G2.
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Affiliation(s)
- Marcos Boaventura de Moura
- Department of Occlusion, Fixed Prosthodontics and Dental Materials, School of Dentistry, Federal University of Uberlandia, Av. Pará 1720, Bloco 4LB, sala 39, Uberlandia, MG, 38405-902, Brazil.
| | - Karine Regina Tolesano Loureiro
- Department of Occlusion, Fixed Prosthodontics and Dental Materials, School of Dentistry, Federal University of Uberlandia, Av. Pará 1720, Bloco 4LB, sala 39, Uberlandia, MG, 38405-902, Brazil
| | - Livia Bonjardim Lima
- Department of Occlusion, Fixed Prosthodontics and Dental Materials, School of Dentistry, Federal University of Uberlandia, Av. Pará 1720, Bloco 4LB, sala 39, Uberlandia, MG, 38405-902, Brazil
| | - Christian Felippi
- Department of Mechanical Engineering, University Federal of Paraná, Curitiba, PR, Brazil
| | - Paulo Cézar Simamoto Júnior
- Department of Occlusion, Fixed Prosthodontics and Dental Materials, School of Dentistry, Federal University of Uberlandia, Av. Pará 1720, Bloco 4LB, sala 39, Uberlandia, MG, 38405-902, Brazil
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Lops D, Stocchero M, Motta Jones J, Freni A, Palazzolo A, Romeo E. Five Degree Internal Conical Connection and Marginal Bone Stability around Subcrestal Implants: A Retrospective Analysis. MATERIALS 2020; 13:ma13143123. [PMID: 32668745 PMCID: PMC7411692 DOI: 10.3390/ma13143123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/05/2020] [Accepted: 07/07/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND There is limited information on the effect of the connection between subcrestally placed implants and abutments on marginal bone levels. The aim of the present retrospective study was to evaluate marginal bone levels after definitive prosthesis delivery around implants with an internal 5° conical connection placed in a subcrestal position. MATERIALS AND METHODS Patients treated with fixed prostheses supported by implants placed at a subcrestal level between 2012 and 2018 were recalled for a follow-up examination. All implants had 5° internal conical connection with platform switching. Radiographic marginal bone level (MBL) was measured. MBL change between prosthetic delivery (t0) and follow-up examination (t1) was calculated. A multiple regression model was performed to identify the most significant predictors on MBL change. RESULTS Ninety-three patients and 410 implants, with a mean follow-up of 2.72 ± 1.31 years, were examined. Mean MBL was -1.09 ± 0.65 mm and -1.00 ± 0.37 mm at t0 and t1, respectively, with a mean bone remodeling of 0.09 ± 0.68 mm. An implant's vertical position in relation to the bone crest, the year of follow up and the presence of type-2 controlled diabetes were demonstrated to be influencing factors for MBL modifications. CONCLUSIONS Subcrestally placed implants with platform switching and internal conical connection maintained stable bone levels over a mean follow-up of more than 2 years. How a tight internal conical connection between abutment and implant may contribute to this clinical evidence should be more deeply investigated. MBL variations seem to be mostly influenced by an implant's vertical position and presence of type-2 controlled diabetes.
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Affiliation(s)
- Diego Lops
- Department of Prosthodontics, Dental Clinic, School of Dentistry, University of Milan, 20142 Milan, Italy; (A.P.); (E.R.)
- Correspondence: ; Tel.: +39-0250319039; Fax: +39-0250319040
| | - Michele Stocchero
- Department of Neurosciences, University of Padova, 35128 Padua, Italy;
| | - Jason Motta Jones
- Department of Oral Surgery, Dental Clinic, Humanitas University, 20089 Milan, Italy;
| | | | - Antonino Palazzolo
- Department of Prosthodontics, Dental Clinic, School of Dentistry, University of Milan, 20142 Milan, Italy; (A.P.); (E.R.)
| | - Eugenio Romeo
- Department of Prosthodontics, Dental Clinic, School of Dentistry, University of Milan, 20142 Milan, Italy; (A.P.); (E.R.)
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Biomechanical Evaluation of the Effects of Implant Neck Wall Thickness and Abutment Screw Size: A 3D Nonlinear Finite Element Analysis. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10103471] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this study, we evaluate the influence of implant neck wall thickness and abutment screw size on alveolar bone and implant component biomechanical responses using nonlinear finite element (FE) analysis. Twelve internal hexagon Morse taper implant–abutment connection FE models with three different implant sizes (diameters 4, 5, and 6 mm), secured with 1.4, 1.6, and 1.8 mm abutment screws to fit with three unilateral implant neck wall thicknesses of 0.45, 0.50, and 1.00 mm, were constructed to perform simulations. Nonlinear contact elements were used to simulate realistic interface fixation within the implant system. A 200 N concentrated force was applied toward the center of a hemispherical load cap and inclined 30° relative to the implant axis as the loading condition. The simulation results indicated that increasing the unilateral implant neck wall thickness from 0.45 to 1.00 mm can significantly decrease implant, abutment, and abutment screw stresses and bone strain, decreased to 58%, 48%, 54%, and 70%, respectively. Variations in abutment screw size only significantly influenced abutment screw stress, and the maximum stress dissipation rates were 10% and 29% when the diameter was increased from 1.4 to 1.6 and 1.8 mm, respectively. We conclude that the unilateral implant neck wall thickness is the major design factor for the implant system and implant neck wall thickness in effectively decreasing implant, abutment, and abutment screw stresses and bone strain.
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The Impact of Implant-Abutment Connection on Clinical Outcomes and Microbial Colonization: A Narrative Review. MATERIALS 2020; 13:ma13051131. [PMID: 32138368 PMCID: PMC7085009 DOI: 10.3390/ma13051131] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/18/2020] [Accepted: 02/27/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Osseointegration are often suffering from oral conditions, especially, the micro gap at the implant-abutment connection represents a site for bacterial plaque aggregation, leading to increased inflammatory cells and causing peri-implantitis. AIM The aim of this narrative review was to describe the different kinds of implant-abutment connections and their ability to reduce bacterial leakage and thus prevent peri-implantitis. MATERIALS AND METHODS The following databases were consulted: Pubmed, Scopus, Cochrane Library, and Research gate and a total of 528 articles were found. After reading the abstract and titles, 473 items were excluded. The remaining articles (n = 55) were assessed for full-text eligibility. Thirty-three studies were included in the review. RESULTS AND CONCLUSIONS We selected 22 clinical trials and 11 reviews, examining a total sample of 2110 implants. From the review, it was clear that there exists a relationship between the implant-abutment interface and bacterial leakage. All the connections presented an amount of micro-gap and bacterial micro-leakage, though conical and mixed connection systems seemed to behave better. Moreover, both connections seemed to have a better load distribution and the mixed system also had anti-rotational properties which are very useful during the positioning of the prosthesis.
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Yao KT, Chang TY, Fang HW, Huang CH, Wang DH, Hsu ML. Abutment screw withdrawal after conical abutment settlement: A pilot study. Clin Oral Implants Res 2019; 31:144-152. [PMID: 31647133 DOI: 10.1111/clr.13550] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/11/2019] [Accepted: 10/19/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study investigated the effects of abutment screw withdrawal after conical abutment settlement on the stability of the implant-abutment connection. MATERIALS AND METHODS Twenty implants of a conical connection system were used. Two two-piece abutment designs were used: cone only (n = 10; NI) and cone plus octagonal index design (n = 10; I); for each design, five samples were used with (S) and without (NS) abutment screw withdrawal before a cyclic test. Finally, four groups, namely Gr S(NI), Gr S(I), Gr NS(NI), and Gr NS(I), were included. The cyclic test included cyclic loading of 20-200 N, 30°, and 4-mm off-axis to implant axis at 10 Hz for 106 cycles, simulating a clinical time interval of 40 months. The fatigue cycles were recorded. The axial displacement of the conical abutments during abutment settlement, screw withdrawal, and cyclic loading were measured. Abutment morphology was examined through scanning electron microscopy (SEM). RESULTS Only Gr NS(NI) failed the test, indicating that without the index design and abutment screw withdrawal, and connection stability seriously deteriorated. Gr NS(I) exhibited significantly higher axial displacement into the implant after abutment settlement than did Gr NS(NI). It also exhibited continuous axial displacement into the implant after cyclic loading. SEM after cyclic testing in Gr NS(I) revealed marked burnishing on lateral edges of the index, indicating that the index design provides an antitorsional ability. CONCLUSION Although this study has few limitations, abutment screw withdrawal is feasible in this conical implant-abutment connection system with index design.
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Affiliation(s)
- Kuang-Ta Yao
- School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Tsai-Yu Chang
- School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Hsu-Wei Fang
- Department of Chemical Engineering and Biotechnology & Institute of Chemical Engineering, National Taipei University of Technology, Taipei, Taiwan.,Division of Medical Engineering Research, National Health Research Institutes, Miaoli, Taiwan
| | - Chang-Hung Huang
- Department of Medical Research, Mackay Memorial Hospital, New Taipei city, Taiwan
| | - Ding-Han Wang
- School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Ming-Lun Hsu
- School of Dentistry, National Yang-Ming University, Taipei, Taiwan
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Kim JC, Lee J, Kim S, Koo KT, Kim HY, Yeo ISL. Influence of implant-abutment connection structure on peri-implant bone level in a second molar: A 1-year randomized controlled trial. J Adv Prosthodont 2019; 11:147-154. [PMID: 31297173 PMCID: PMC6609760 DOI: 10.4047/jap.2019.11.3.147] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 04/30/2019] [Accepted: 06/11/2019] [Indexed: 11/12/2022] Open
Abstract
PURPOSE This study aimed to evaluate the effect of two different implant-abutment connection structures with identical implant design on peri-implant bone level. MATERIALS AND METHODS This clinical study was a patient-blind randomized controlled trial following the CONSORT 2010 checklists. This trial was conducted in 24 patients recruited between March 2013 and July 2015. Implants with internal friction connection were compared to those with external hex connection. One implant for each patient was installed, replacing the second molar. Implant-supported crowns were delivered at four months after implant insertion. Standardized periapical radiographs were taken at prosthesis delivery (baseline), and one year after delivery. On the radiographs, distance from implant shoulder to first bone-to-implant contact (DIB) and peri-implant area were measured, which were the primary and secondary outcome, respectively. RESULTS Eleven external and eleven internal implants were analyzed. Mean changes of DIB from baseline to 1-year postloading were 0.59 (0.95) mm for the external and 0.01 (0.68) mm for the internal connection. Although no significant differences were found between the two groups, medium effect size was found in DIB between the connections (Cohen's d = 0.67). CONCLUSION Considering the effect size in DIB, this study suggested the possibility of the internal friction connection structure for more effective preservation of marginal bone.
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Affiliation(s)
- Jin-Cheol Kim
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Jungwon Lee
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Sungtae Kim
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Ki-Tae Koo
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Hae-Young Kim
- Department of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea
| | - In-Sung Luke Yeo
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
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Yao KT, Kao HC, Cheng CK, Fang HW, Huang CH, Hsu ML. Mechanical performance of conical implant-abutment connections under different cyclic loading conditions. J Mech Behav Biomed Mater 2019; 90:426-432. [DOI: 10.1016/j.jmbbm.2018.10.039] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 06/26/2018] [Accepted: 10/30/2018] [Indexed: 11/24/2022]
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Kim SJ, Son K, Lee KB. Digital evaluation of axial displacement by implant-abutment connection type: An in vitro study. J Adv Prosthodont 2018; 10:388-394. [PMID: 30370031 PMCID: PMC6202430 DOI: 10.4047/jap.2018.10.5.388] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/22/2018] [Accepted: 08/28/2018] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To measure axial displacement of different implant-abutment connection types and materials during screw tightening at the recommended torque by using a contact scanner for two-dimensional (2D) and three-dimensional (3D) analyses. MATERIALS AND METHODS Twenty models of missing mandibular left second premolars were 3D-printed and implant fixtures were placed at the same position by using a surgical guide. External and internal fixtures were used. Three implant-abutment internal connection (INT) types and one implant-abutment external connection (EXT) type were prepared. Two of the INT types used titanium abutment and zirconia abutment; the other INT type was a customized abutment, fabricated by using a computer-controlled milling machine. The EXT type used titanium abutment. Screws were tightened at 10 N·cm, simulating hand tightening, and then at the manufacturers' recommended torque (30 N·cm) 10 min later. Abutments and adjacent teeth were subsequently scanned with a contact scanner for 2D and 3D analyses using a 3D inspection software. RESULTS Significant differences were observed in axial displacement according to the type of implant-abutment connection (P<.001). Vertical displacement of abutments was greater than overall displacement, and significant differences in vertical and overall displacement were observed among the four connection types (P<.05). CONCLUSION Displacement according to connection type and material should be considered in choosing an implant abutment. When adjusting a prosthesis, tightening the screw at the manufacturers' recommended torque is advisable, rather than the level of hand tightening.
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Affiliation(s)
- Sung-Jun Kim
- Department of Dentistry, Graduate School, Kyungpook National University, Daegu, Republic of Korea
| | - KeunBaDa Son
- Department of Dental Science, Graduate School, Kyungpook National University, Daegu, Republic of Korea.,Advanced Dental Device Development Institute, Kyungpook National University, Daegu, Republic of Korea
| | - Kyu-Bok Lee
- Department of Dentistry, Graduate School, Kyungpook National University, Daegu, Republic of Korea.,Department of Dental Science, Graduate School, Kyungpook National University, Daegu, Republic of Korea.,Advanced Dental Device Development Institute, Kyungpook National University, Daegu, Republic of Korea
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Huang B, Zhang L, Xu L, Zhu W, Witek L, Tovar N, Coelho PG, Meng H. Effect of implant placement depth on the peri-implant bone defect configurations in ligature-induced peri-implantitis: An experimental study in dogs. Med Oral Patol Oral Cir Bucal 2018; 23:e30-e37. [PMID: 29274159 PMCID: PMC5822536 DOI: 10.4317/medoral.22032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Indexed: 11/24/2022] Open
Abstract
Background The subcrestal placement of implant platform has been considered a key factor in the preservation of crestal bone, but the influence of implant placement depth on bone remodeling combined with peri-implantitis is not fully understood. The aim of this study was to assess the effect of the crestal or subcrestal placement of implants on peri-implant bone defects of ligature-induced peri-implantitis in dogs. Material and Methods Eight weeks after tooth extraction in six beagle dogs, two different types of implants (A: OsseoSpeed™, Astra, Mölndal, Sweden; B: Integra-CP™, Bicon, Boston, USA) were placed at either crestal or subcrestal (-1.5 mm) positions on one side of the mandible. Ligature-induced peri-implantitis was initiated four weeks after the installation of the healing abutment connections. After 12 weeks, tissue biopsies were processed for histological analyses. Results Supra-alveolar bone loss combined with a shallow infrabony defect was observed in crestal level implants while deep and wide infrabony defects were present in subcrestal level groups. Subcrestal groups showed significantly greater ridge loss, depths and widths of infrabony defects when compared to crestal groups (P<0.001). Conclusions Within the limitations of the animal study, it can be stated that the implants at subcrestal position displayed greater infra-osseous defect than implants at crestal position under an experimental ligature-induced peri-implantitis. Key words:Subcrestal, peri-implantitis, histology.
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Affiliation(s)
- B Huang
- Department of Periodontology, Peking University, School and Hospital of Stomatology, zhongguancun nandajie No.22, Haidian District, Beijing 100081, China,
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Abstract
PURPOSE To evaluate the effect of blasting and bonding on abutment surface to prevent screw loosening in Morse taper connections. MATERIAL AND METHODS Twenty-eight Morse taper connection implants were divided into 4 groups: no treatment (G1), blasting (G2), bonding (G3), and blasting + bonding (G4). In groups G2 and G4, the abutments were blasted with aluminum oxide granules; in groups G3 and G4, the conical abutment region was covered with a thin layer of bond thread lock agent. In all implants, the abutment-implant joint was tightened at a torque of 35 Ncm. The specimens were submitted to the mechanical cycling, under an oblique load for 1.0 × 10 cycles. The torque was measured with a digital torque meter. Data were analyzed by the t test, one-way analysis of variance, and Tukey tests (95%). RESULTS The loosening strength was significantly higher in group G4 (35.83 ± 3.02 Ncm). There was no significant difference among groups G1 (25.86 ± 1.96 Ncm), G2 (25.86 ± 3.29 Ncm), and G3 (26.14 ± 2.12 Ncm). CONCLUSION The association of blasting and bonding on abutment surface can be used to prevent screw loosening in Morse taper implants.
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A New Model to Study Fatigue in Dental Implants Based on Probabilistic Finite Elements and Cumulative Damage Model. Appl Bionics Biomech 2017; 2017:3726361. [PMID: 28757795 PMCID: PMC5516717 DOI: 10.1155/2017/3726361] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 04/06/2017] [Accepted: 04/27/2017] [Indexed: 12/14/2022] Open
Abstract
The aim of this study was to predict the fatigue life of two different connections of a dental implant as in load transfer to bone. Two three-dimensional models were created and assembled. All models were subjected to a natural masticatory force of 118 N in the angle of 75° to the occlusal plane. All degrees of freedom in the inferior border of the cortical bone were restrained, and the mesial and distal borders of the end of the bone section were constrained. Fatigue material data and loads were assumed as random variables. Maximum principal stresses on bone were evaluated. Then, the probability of failure was obtained by the probabilistic approach. The maximum principal stress distribution predicted in the cortical and trabecular bone is 32 MPa for external connection and 39 MPa for internal connection. A mean life of 103 and 210 million cycles were obtained for external and internal connection, respectively. Probability cumulative function was also evaluated for both connection types. This stochastic model employs a cumulative damage model and probabilistic finite element method. This methodology allows the possibility of measured uncertainties and has a good precision on the results.
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Jeng MD, Liu PY, Kuo JH, Lin CL. Load Fatigue Performance Evaluation on Two Internal Tapered Abutment–Implant Connection Implants Under Different Screw Tightening Torques. J ORAL IMPLANTOL 2017; 43:107-113. [DOI: 10.1563/aaid-joi-d-16-00129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study evaluates the load fatigue performance of different abutment–implant connection implant types—retaining-screw (RS) and taper integrated screwed-in (TIS) types under 3 applied torque levels based on the screw elastic limit. Three torque levels—the recommended torque (25 Ncm), 10% less, and 10% more than the ratio of recommended torque to screw elastic limits of different implants were applied to the implants to perform static and dynamic testing according to the ISO 14801 method. Removal torque loss was calculated for each group after the endurance limitation was reached (passed 5 × 106 cycles) in the fatigue test. The static fracture resistance results showed that the fracture resistance in the TIS-type implant significantly increased (P < .05) when the abutment screw was inserted tightly. The dynamic testing results showed that the endurance limitations for the RS-type implant were 229 N, 197 N, and 224 N and those for the TIS-type implant were 322 N, 364 N, and 376 N when the screw insertion torques were applied from low to high. The corresponding significant (P < .05) removal torque losses for the TIS-type implant were 13.2%, 5.3%, and 2.6% but no significant difference was found for the RS-type implant. This study concluded that the static fracture resistance and dynamic endurance limitation of the TIS-type implant (1-piece solid abutment) increased when torque was applied more tightly on the screw. Less torque loss was also found when increasing the screw insertion torque.
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Affiliation(s)
- Ming-Dih Jeng
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Po-Yi Liu
- Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan
| | - Jia-Hum Kuo
- Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan
| | - Chun-Li Lin
- Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan
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