Figure 2. ture. Temperature rise at 30 s: bone level 3.3 mm > bone level 4.1 mm > Straumann regular neck 3.3 mm = Astra 3.5 mm = Straumann regular neck 4.8 mm. (b) Temperature rise when instrumenting with the Satelec ultrasonic device with cooling. The horizontal dotted line denotes the assumed critical rise in temperature. Temperature rise at 30 s: bone level 3.3 mm =â...
Figure 1. Implant embedded in epoxy resin with thermocouple at the outer surface.
Figure 1. Implant embedded in epoxy resin with thermocouple at the outer surface.
Meisberger, E.W., Bakker, S.J.G. & Cune, M.S. Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types. Int J Implant Dent 1, 7 (2015). https://doi.org/10.1186/s40729-015-0008-0
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Received: 19 December 2014
Accepted: 02 March 2015
Published: 20 March 2015
DOI: https://doi.org/10.1...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and in...
This research was made possible by the support of the authors’ institutions. Eric W Meisberger, Sjoerd JG Bakker and Marco S Cune declare that they have no competing interests.
EM and SB carried out the experiment. MC participated in the design of the study and performed the statistical analysis and helped to draft the manuscript. All authors read and approved the final manuscript.
University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Fixed and Removable Prosthodontics and Biomaterials, The University of Groningen, Gebouw 3216, kamer 206, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands
Eric W Meisberger, Sjoerd J G Bakker & Marco S Cune
Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, St. Antoniu...
The input of Prashant K. Sharma PhD, material scientist of the Department of Biomedical Engineering (Kolff Institute) of the UMC Groningen is greatly appreciated for his help interpreting the data. Michael Kars, DDS assisted during the collection of the data.
Satterthwaite JD, Stokes AN, Frankel NT. Potential for temperature change during application of ultrasonic vibration to intra-radicular posts. Eur J Prosthodont Restor Dent. 2003;11:51–6.
Horan BB, Tordik PA, Imamura G, Goodell GG. Effect of dentin thickness on root surface temperature of teeth undergoing ultrasonic removal of posts. J Endod. 2008;34:453–5.
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Benington IC, Biagioni PA, Briggs J, Sheridan S, Lamey PJ. Thermal changes observed at implant sites during internal and external irrigation. Clin Oral Implants Res. 2002;13:293–7.
Li S, Chien S, Branemark PI. Heat shock-induce...
Assenza B, Tripodi D, Scarano A, Perrotti V, Piattelli A, Iezzi G, et al. Bacterial leakage in implants with different implant-abutment connections: an in vitro study. J Periodontol. 2011;83:491–7.
Ha CY, Lim YJ, Kim MJ, Choi JH. The influence of abutment angulation on screw loosening of implants in the anterior maxilla. Int J Oral Maxillofac Implants. 2011;26:45–55.
Spazzin AO, Henrique GE,...
Sailer I, Philipp A, Zembic A, Pjetursson BE, Hammerle CH, Zwahlen M. A systematic review of the performance of ceramic and metal implant abutments supporting fixed implant reconstructions. Clin Oral Implants Res. 2009;20 Suppl 4:4–31.
Romeo E, Storelli S. Systematic review of the survival rate and the biological, technical, and aesthetic complications of fixed dental prostheses with cantilever...
It is concluded from this in vitro study that heat accumulation and transfer is dependent on the type of ultrasonic device, the use of coolant, and the implant type. The highest rise in temperature is seen when using the Satelec device without coolant on the smaller diameter implants. The EMS device causes limited rise in temperature when used without coolant for less than 10Â s, but presumably de...
Cooling proves effective for both systems, increasing the outer implant temperature by an acceptable 1°C to 3°C during continued instrumentation; however, as already stated, the spray will blur the vision of the operator.
One would expect the temperature to drop immediately after cessation of instrumentation and cooling, but the peak temperature is reached some seconds later for all experimenta...
The degree to which a material is able to transfer heat is called thermal conductivity. It can be defined as the time rate of transfer by conduction, through unit thickness, across unit area for unit temperature gradient. Differences in design and wall thickness of the implants used in the present study account for the variation in outcome (i.e., Straumann tissue level 4.8 implant less effected), ...
Several techniques have been described to deal with biomechanical complications. Acquiring adequate visibility and access is essential to success which will require the use of a dental microscope.
Several mechanical approaches to remove screw remnants can be employed. Generally, after identifying the position and condition of the screw remnant, it can be carefully removed using manual instrumenta...
The mean maximum rise in temperature (deltaTmax, all implants averaged per experimental condition) was reached at 30 to 40 s for all conditions. There was a significant difference for the Satelec device without cooling (mean 9.6, SD 1.6°C) and the EMS device without cooling (mean 4.3, SD 2.0°C) (t-test, t(28) = 4.7, p 
The results for all implants instrumented with the two tested ultrasonic devices, either with or without cooling, are presented in Figure 2a,b,c,d.
For the Satelec device, applied without coolant, only the temperature of the Straumann wide body regular neck implant never exceeded the 50 threshold. The data proved normally distributed (Kolmogorov-Smirnov test, p > 0.05). Analysis of variance ...
Two different types of commercially available ultrasonic devices, set at their lowest intensity for endodontic purpose, were used to instrument the internal portion of five different implant types, either with or without cooling. Intermittent anti-clockwise strokes were made, assuring that the tip was constantly in contact with the inner implant wall, as much as possible mimicking the motion that ...
The use of ultrasonic equipment under adequate magnification may facilitate removal. It generates heat. Instrumentation without a coolant likely increases the temperature of the implant body and could cause tissue damage, in particular be harmful to osseointegration. The use of a coolant could be effective, but compromises visibility considerably, hence increases the risk of damaging the internal ...
Complications in implant dentistry are generally divided into biological and mechanical complications. Mechanical complications include fracture of the implant body or prosthetic components such as chipping of ceramic material as well as loosening or fracture of implant abutments or fixation screws. This has a documented prevalence of 6 to 13% and 0.4 to 2% respectively after 5Â years [1-7].
With...
Ultrasonic instrumentation under magnification may facilitate mobilization of screw remnants but may induce heat trauma to surrounding bone. An increase of 5°C is considered detrimental to osseointegration. The objective of this investigation was to examine the rise in temperature of the outer implant body after 30 s of ultrasonic instrumentation to the inner part, in relation to implant type, t...
Tsuruta, K., Ayukawa, Y., Matsuzaki, T. et al. The influence of implant–abutment connection on the screw loosening and microleakage.
Int J Implant Dent 4, 11 (2018). https://doi.org/10.1186/s40729-018-0121-y
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Received: 20 November 2017
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Published: 09 April 2018
DOI: https://doi.org/10.1186/s40729-018-0121-y
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
The present study was not required ethical approval.
Katsuhiro Tsuruta, Yasunori Ayukawa, Tatsuya Matsuzaki, Masafumi Kihara, and Kiyoshi Koyano declare that they have no competing interests.
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Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 8128582, Japan
Katsuhiro Tsuruta, Yasunori Ayukawa, Tatsuya Matsuzaki, Masafumi Kihara & Kiyoshi Koyano
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Tsuge T, Hagiwara Y, Matsumura H. Marginal fit and microgaps of implant-abutment interface with internal anti-rotation configuration. Dent Mater J. 2008;27:29–34.
Scarano A, Valbonetti L, Degidi M, Pecci R, Piattelli A, de Oliveira PS, et al. Implant-abutment conta...
Sakka S, Baroudi K, Nassani MZ. Factors associated with early and late failure of dental implants. J Investig Clin Dent. 2012;3:258–61.
Tallarico M, Canullo L, Caneva M, Ozcan M. Microbial colonization at the implant-abutment interface and its possible influence on periimplantitis: a systematic review and meta-analysis. J Prosthodont Res. 2017;61:233–41.
Sasada Y, Cochran DL. Implant-abutmen...
Within the limitation of the present study, after the offset cyclic tensile and compressive loading, the amount of microleakage from implant–abutment interface was smaller in conical connection than in internal parallel connection.
In the present study, chronological increase of the amount of microleakage was observed in all three groups. This is in consistent with previous studies [5, 13, 15, 16]. Sigmoid curves of microleakage in all groups meant that the amount of leakage was large at the early stage of loading. This was in agreement with previous reports. Harder et al. reported that bacterial toxin leak occurred within 5...
In the present study, cyclic tensile and compressive loading were applied to cantilever superstructure. In the clinical situation, both compressive and tensile force was exerted to implant-supported prosthesis, but no previous study has discussed the microleakage using model study under this situation. In case of conical connection, compressive force may have promoted a higher penetration of the a...
During the experiment, one (EP) and two (IP) abutment screws out of seven samples were fractured. In this case, abutment screw was changed to new one and experimental procedure was re-run.
After the 2000Â cycles of compressive tensile loadings, RTV of abutment screw was measured. There were no statistical differences in the RTV among three groups. Standard deviation was largest in the RTV of EP a...
Three kinds of Nobel Biocare implants were employed in the present study, namely, Nobel SpeedyGroovy WP 5.0 × 15 mm (EP), Nobel Replace WP 5.0 × 15 mm (IP), and Nobel Parallel CC RP 5.0 × 15 mm (CC) (n = 7 each) (Nobel Biocare, Kloten, Switzerland). Implant–abutment connections are external, internal parallel, and internal and conical connection, respectively. Implant was e...
Although promising outcome of implant therapy has been reported, periimplantitis which is known to be one of the most important factors associated with late failure [1] is a serious complication and expected to overcome to obtain successful outcome. It is known that there are some spaces between abutment and implant body which can be a reservoir of microorganisms and other toxic substance [2], and...
There are some spaces between abutment and implant body which can be a reservoir of toxic substance, and they can penetrate into subgingival space from microgap at the implant–abutment interface. This penetration may cause periimplantitis which is known to be one of the most important factors associated with late failure. In the present study, three kinds of abutment connection system, external ...
Fig. 6. Comparison between short and high collar length (A and B)
Fig. 6. Comparison between short and high collar length (A and B)
Fig. 5. Mean rate ± SD of removal torque loss (%) between groups and results of ANOVA test for loss ratio of removal torque value between groups
Fig. 5. Mean rate ± SD of removal torque loss (%) between groups and results of ANOVA test for loss ratio of removal torque value between groups
Fig. 4. Application of cyclic loading with universal testing machine
Fig. 4. Application of cyclic loading with universal testing machine
Fig. 3. 3D scanning for abutment and designing for metal tube
Fig. 3. 3D scanning for abutment and designing for metal tube
Fig. 2. a Stainless steel split cylindrical mold with implant fixture screwed to abutment. b Implant fixture unscrewed from abutment after polymerization. c Implant fixture centralized vertically and perpendicular to the base with platform flushed with resin block level
Fig. 2. a Stainless steel split cylindrical mold with implant fixture screwed to abutment. b Implant fixture unscrewed from ...
Fig. 1. Different abutment angulations and collar lengths
Fig. 1. Different abutment angulations and collar lengths
N
Groups
Subgroups
Initial RTV
Postload RTV
Initial RTL
Postload RTL
...
Collar length
Subgroups
T test
A (2Â mm collar length)
B (4Â mm collar length)
t
P value
Initial RTV
...
Â
Initial RTV
Postload RTV
Difference between initial and postload RTV
Mean ± SD
Subgroups
 GIA
...
Â
%initial RTL
%postload RTL
%difference between initial and postload RTL
Mean ± SD
Subgroups
 GIA
...
El-Sheikh, M.A.Y., Mostafa, T.M.N. & El-Sheikh, M.M. Effect of different angulations and collar lengths of conical hybrid implant abutment on screw loosening after dynamic cyclic loading.
Int J Implant Dent 4, 39 (2018). https://doi.org/10.1186/s40729-018-0149-z
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Received: 07 May 2018
Accepted: 11 October 2018
Published: 03 December 2018
DOI: https://doi....
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
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Mai El-sheikh, Tamer Mostafa, and Mohamed El-Sheikh declare that they have no competing interests.
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Prosthodontic Department, Faculty of Dentistry, Tanta University, Elgeish St., Tanta, Egypt
Mai Ahmed Yousry El-Sheikh, Tamer Mohamed Nasr Mostafa & Mohamed Maamoun El-Sheikh
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The authors declare that they have full control on all data and materials of this study.
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Hsu ML, Chung TF, Kao HC. Clinical applications of angled abutments - a literature review. Chin Dent J. 2005;24:15–21.
Morsch CS, Rafael...
Cavallaro JG, Greenstein G. Angled implant abutments. A Practical Application of Available Knowledge J Am Dent Assoc. 2011;142:150–8.
Kallus T, Henry P, Jemt T, Jorneus L. Clinical evaluation of angulated abutments for the Branemark system: a pilot study. Int J Oral Maxillofac Implants. 1990;5:39–45.
Herrero-Climent M, Romero-Ruiz MM, Diaz-Castro CM, Bullon P, Rios-Santos JV. Influence of tw...
Prado CJ, Neves FD, Soares CJ, Dantas KA, Dantas TS, Naves LZ. Influence of abutment screw design and surface coating on the bending flexural strength of the implant set. J Oral Implantol. 2014;40:123–8.
Goodacre CJ, Bernal G, Rungcharassaeng K, Kan JY. Clinical complications with implants and implant prostheses. J Prosthet Dent. 2003;90:121–32.
Michalakis KX, Calvani PL, Muftu S, Pissiotis ...
Within the limitations of this in vitro study, it can be concluded that:
Screw loosening increases with increasing abutment angulation and collar length after 100,000Â cycles of dynamic cyclic loading.
Results of this study showed that conical hybrid connection design provides more biomechanically stable screw joint with straight abutments than angled abutments.
Several studies have been conducted on this type of implant–abutment connection [23, 34]. Sutter et al. [35] demonstrated reverse torque values of this hybrid implant–abutment connection that were 124% of the initial tightening torque. These authors suggested that cold welding occurred in the conical hybrid implant–abutment connection.
Schmitt et al. [36] compared conical and nonconical imp...
The increase in RTL with increasing abutment angulation can be attributed to the off-axis force as loading on angled abutments is mostly off-axis, which raises the concern of how angled abutments generally perform with such an unfavorable loading regimen [28]. Forces applied off-axis may be expected to overload the bone surrounding single-tooth implants, as shown by means of finite element analysi...
In the current study, the results showed that there is a significant difference in %RTL before and after application of dynamic cyclic loading for all angulations and collar lengths. These results are in an agreement with previous researches that found a significant difference between %initial and %postload RTL after mechanical cyclic loading [24, 25]. This result was explained by Bickford et al. ...
Conical hybrid connection was used in this study as it was proven that the conical hybrid demonstrated the best stress distribution [20]. This connection has a conical union between the implant fixture and the abutment. In the conical abutment, lateral force is resisted by the taper design of the Morse taper connection. Thus, the stress concentration is resisted by the side-wall contact surface of...
One-way ANOVA and pair-wise Tukey’s post hoc tests showed that %initial RTL among the groups was not significantly different (P > .05), while %postload RTL was significantly different among the three groups (P 
Removal torque loss ratio before loading (%initial RTL)
Removal torque loss ratio after loading (%postload RTL)
Removal torque loss ratio between before and after loading (%difference between initial and postload RTL)
Student T test and ANOVA were used to compare mean of %initial and %postload RTL between different groups and subgroups followed by pair-wise Tukey’s post hoc tests at 0.05 leve...
Self-adhesive resin cement (G- CEM, USA) was used for fixing of metal tube to the abutment. A customized rigid metal mounting jig was designed, as a holding device, to ensure solid fixation of the sample while recording the measures.
Abutment screws were tightened in all the groups to 30 Ncm using a digital torque gauge (HTG2 - 200Nc, IMADA, Toyohashi, Japan) according to the manufacturer’s re...
Total 90 stock titanium abutments (Anyridges; MEGAGEN, Seoul, Korea) with different angulations and collar lengths were used in this study and divided into three groups, 30 each according to the degree of abutment angulations GI 0° abutment, GII 15° abutment, and GIII 25°. Each group was divided into two subgroups, 15 each according to implant abutment collar lengths: subgroup A (2 mm) and sub...
To date, there are limited publications regarding the investigation of screw loosening according to abutment angulations and collar lengths before and after dynamic cyclic loading. Sethi and colleagues [19] noted no implant fractures or screw loosening during a 96-month monitoring period for 2261 implants (N = 467 patients) with angulations ranging from 0 to 45°. While Asvanund and colleagues...
Collar length is the distance between the implant platform and the gingival margin. Sometimes, significant vertical space that has not been corrected with vertical ridge augmentation may necessitate selection of longer abutments, which would lead to an increased vertical cantilever. Furthermore, selection of the length of abutment collar would be affected if different distances between the implant...
When the implant set is submitted to functional loads, occlusal forces to the connection are concentrated at the abutment screw; consequently, the optimum preload is critical for joint stability and to avoid screw loosening [7].
Several factors related to screw design and fabrication can affect the risk of abutment or prosthetic screw loosening in a metal-to-metal screw system; these primarily ar...
Successful implant therapy requires a dynamic equilibrium between biological and mechanical factors. The mechanical factors are generally considered multifactorial which are involved in the success of implant rehabilitation. Majority of implant complications nowadays are caused by mechanical factors rather than the implant itself. Mechanical complications of the implant-prosthetic system include l...
The purpose of this in vitro study was to evaluate the effect of different angulations and collar lengths of the implant abutment on screw loosening by measuring removal torque value (RTV) before and after dynamic cyclic loading using digital torque gauge.
A total 90 sets of 4.5 mm diameter × 10 mm length bone level implants with conical hybrid connection were used. They were divided equally...
Fig. 8. Change in RTVs according to the numbers of mechanical loading cycles
Fig. 8. Change in RTVs according to the numbers of mechanical loading cycles
Fig. 7. Schematic diagram for experimental procedure
Fig. 7. Schematic diagram for experimental procedure
Fig. 6. Specimen mounted in a 30°-angled steel holder
Fig. 6. Specimen mounted in a 30°-angled steel holder
Fig. 5. Specimen mounted in a 30°-angled steel holder in ElectroPuls E1000 dynamic testing machine
Fig. 5. Specimen mounted in a 30°-angled steel holder in ElectroPuls E1000 dynamic testing machine
Fig. 4. Tightening the abutment screw and measuring the RTVs
Fig. 4. Tightening the abutment screw and measuring the RTVs
Fig. 3. Implant assembly embedded in resin block
Fig. 3. Implant assembly embedded in resin block
Fig. 2. Schematic of test setup according to The ISO 14801 recommendations
Fig. 2. Schematic of test setup according to The ISO 14801 recommendations
Fig. 1. Cone connection combined with octalobular index (Octatorx)
Fig. 1. Cone connection combined with octalobular index (Octatorx)
Benjaboonyazit, K., Chaijareenont, P. & Khongkhunthian, P. Removal torque pattern of a combined cone and octalobule index implant-abutment connection at different cyclic loading: an in-vitro experimental study.
Int J Implant Dent 5, 1 (2019). https://doi.org/10.1186/s40729-018-0154-2
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Received: 17 September 2018
Accepted: 20 December 2018
Published: 14 Jan...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
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Kanyarin Benjaboonyazit, Pisaisit Chaijareenont, and Pathawee, Khongkhunthian declare that they have no competing interests.
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Center of Excellence for Dental Implantology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
Kanyarin Benjaboonyazit
Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
Pisaisit Chaijareenont
Center of Excellence for Dental Implantology, Faculty of Dentistry, Chiang Mai University, Suthep, A. Muang, Chiang Mai, 50200, Thailand
Pat...
The authors sincerely thank Mr. Anucharte Srijunbarl, Dental Material Research Center, Faculty of Dentistry, Chulalongkorn University for his assistance in the experimental part, Dr.Thanapat Sastraruji, Dental Research Center, Faculty of Dentistry, Chiang Mai University for his help in the meteorological data analysis and Dr. M. Kevin O Carroll, Professor Emeritus of the University of Mississippi ...
Khraisat A, Abu-Hammad O, Dar-Odeh N, Al-Kayed AM. Abutment screw loosening and bending resistance of external hexagon implant system after lateral cyclic loading. Clin Implant Dent Relat Res. 2004;6:43–164.
Guzaitis KL, Knoernschild KL, Viana MAG. Effect of repeated screw joint closing and opening cycles on implant prosthetic screw reverse torque and implant and screw thread morphology. J Pros...
Cibirka RM, Nelson SK, Lang BR, Rueggeberg FA. Examination of the implant-abutment interface after fatigue testing. J Prosthet Dent. 2001;85:268–75.
Khraisat A, Hashimoto A, Nomura S, Miyakawa O. Effect of lateral cyclic loading on abutment screw loosening of an external hexagon implant system. J Prosthet Dent. 2004;91:326–34.
Delben JA, Gomes EA, Barao VA, Assuncao WG. Evaluation of the eff...
Maeda Y, Satoh T, Sogo M. In vitro differences of stress concentrations for internal and external hex implant-abutment connections: a short communication. J Oral Rehabil. 2006;33:75–8.
Ma T, Nicholls JI, Rubenstein JE. Tolerance measurements of various implant components. Iny J Oral Maxillofac Implants. 1997;12:371–5.
Merz BR, Hunenbart S, Belser UC. Mechanics of the implant-abutment connect...
Pjetursson BE, Asgeirsson AG, Zwahlen M, Sailer I. Improvements in implant dentistry over the last decade: comparison of survival and complication rates in older and newer publications. Int J Oral Maxillofac Implants. 2014;29(Suppl):308–24.
Jung RE, Pjetursson BE, Glauser R, Zembic A, Zwahlen M, Lang NP. A systematic review of the 5-year survival and complication rates of implant-supported sing...
According to the conditions for the fatigue test set out in ISO 14801:2007, the RTVs of the combined cone and octalobule index reduced significantly after 50,000 cycles and did not change significantly until 2,000,000 cycles.
In addition, further studies are suggested to examine the relation between the settling value [38] and the preload value of the screw. It would be helpful for evaluating the stability of the implant-abutment connection after functional loading. The decreasing pattern of RTVs after cyclic loading was specific to the design of the implant-abutment connection, so more studies are recommended in other...
Tzenakis et al. [42] reported that retightening of the screw is strongly recommended, but the appropriate timing of retightening is still not clear. Cho et al. [39] recommended retightening abutment screws in the early stage of functional loading, at the first week in vivo, in internal type implants because they found no significant difference in RTVs between 20,000 and 100,000 cycles of loading...
Although the reduction in RTVs was observed after mechanical cyclic loading, no screw loosening occurred after 2,000,000 cycles of loading, which it assumed represents 3 years of function in worse scenario setting according to ISO 14801 in vivo [23]. Our study presents similar results to those of Binon and McHugh, who reported that the 30-N-cm insertion torque can maintain screw-joint stabilit...
From the study, the RTVs of the control group, which was left unloaded for 10 min after second tightening decreased 7.78% from the tightening torque. Previous studies have shown a 2 to 10% loss of screw preload [21]. These results can be explained by the settling effect as follows [16]. Firstly, the tightening torque is used to overcome the friction of the contacting metal surface connection [32...
The RTV data were normally distributed (Shapiro-Wilk test). The mean RTVs (N cm) of all groups are shown in Table 1. The RTVs in all groups decreased. The mean initial RTV of the control group was 27.67 N cm, a decrease of 7.78% compared to the insertion torque. After mechanical cyclic loading, all experimental groups from 50,000 to 2,000,000 cycles of loading showed significant decreases i...
Statistical analysis was performed using one-way ANOVA for the overall effect of the numbers of mechanical loading cycles on the RTVs of the abutment screw as well as the post hoc Tukey’s HSD test SPSS 20 (IBM SPSS, Chicago, IL, USA) was used, and differences at P 
This study was conducted in accordance to the international standard fatigue test (ISO 14801:2007) for endosseous dental implants in vitro (Fig. 2). Eighty-four implants (PW Plus implant system, PW Plus Company) were prepared, which had a diameter of 3.75 mm and a length of 10 mm, with the Octatorx-cone implant-abutment connection. All were embedded in individual epoxy resin blocks (Chockfast ...
Bickford has explained how the screw is loosened in two stages [19]. Firstly, an external force causes micromovement and slipping between the abutment screw thread and the implant, decreasing the screw preload. Secondly, if the preload value falls below a critical level, and the external force exceeds the joint separating force, then screw loosening occurs. Consequently, the higher the preload val...
The occlusal force does not load only on the screw. The internal conical connection interface also helps to transfer and distribute the loading force to the implant [13]. The axial compressive component of occlusal force during oral function causes axial displacement of the abutment to the implant connection, increasing the frictional resistance and screw joint stability of the dental implant [7, ...
Dental implant placement has shown high survival and success rates [1, 2]. According to one study, the overall 5-year prosthetic survival rate for implant treatment has increased from 93.5 to 97.1% during the past 10 years [1]. Despite the high survival rate of implants, technical complications, such as screw loosening, are frequently reported [1,2,3]. The 5-year complication rate for screw loos...
Despite the high survival rate of dental implants, screw loosening is frequently reported. Screw loosening can cause a misfit of the implant-abutment connection leading to peri-implantitis or abutment screw fracture. Therefore, studies about related factors and mechanism of screw loosening are needed. The aim of this study was to evaluate the decreasing pattern of removal torque values (RTVs) of a...
Â
Figure 6. SEM picture of implant with external hexagonal connection
Figure 5. SEM picture of CAMLOG implant after torsion test
Figure 5. SEM picture of CAMLOG implant after torsion test
Â
Figure 4. The mean value of torsional yield strength
Â
Figure 3. The mean value of maximum fracture torque strength
Figure 1. Torsion testing device
For comparison between the mechanical strength of CP-Ti screw implants with internal tube-in-tube implant-abutment connections and that of external hexagonal-type connections, all abutments and CP-Ti implants with external hexagonal-type connections were heavily damaged or destroyed in all phases of loading. A typical fracture curve for CP-Ti implants with external connections is shown. The propor...
Discussion
During the physiological function of chewing, or the non-physiological function of bruxism, compressive, bending, and torsional stresses are generated in teeth or prosthetics. These stress will cause the abutment screw loosening or fracture, fracture of the abutment, fracture of the implant, and the implant/abutment connection. The extent of the damage is influenced by the design o...
Methods
Thirty titanium screw implants of five different diameters (3.3, 3.8, 4.3, 5.0, and 6.0 mm) with tube-in-tube implant-abutment connections (CAMLOG Biotechnologies, Wimsheim, Germany) were used as test specimens. Implants of each size were connected to abutments, and abutment screws were tightened to 20 N · cm using a digital torque meter (Hios HDM-5; Hios Inc, Chiba...
Background
A single-tooth osseointegrated implant is composed of an implant body, an abutment, an abutment screw, and an artificial crown. The implant and abutment are typically connected by an abutment screw. The degree of mechanical integrity at the implant-abutment interface depends on screw preload, abutment connection design, the fitness of all components, and dynamic loading conditions. F...
Abstract
Background
Fractured connections between implants and implant abutments or abutment screws are frequently encountered in a clinical setting. The purpose of this study was to investigate fracture strength using a torsion test at the interface between the implant and the abutment.
Methods
Thirty screw-type implant with diameters of 3.3, 3.8, 4.3, 5.0, and 6.0Â mm were submitted to a t...
Figure 3. Representative SEM images of healing abutments after electrolysis of different charges and currents for 10 V and 5 min (all images × 1000 magnification)
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Figure 3. Representative SEM images of healing abutments after electrolysis of different charges and currents for 10 V and 5 min (all images × 1000 magnification)
Figure 2. Microscopical images of the healing abutments after the electrochemical treatments under different currents at constant 10 V with different electrodes. The healing abutments were stained with phloxine B after electrolysis. Images from side (a, c, e, g, i, k) and from top (b, d, f, h, j, l). a, b 1 A group I. c, d 1.5 A group I. e, f 1 A group II. g, h 1.5 A group II. i, j 1 A...
Figure 1. The amount of residual contamination after electrochemical treatments under different charges and currents at constant 10 V. Mean ± SD (n = 5). *P < 0.05, **P < 0.01, ***P < 0.005
Figure 1. The amount of residual contamination after electrochemical treatments under different charges and currents at constant 10 V. Mean ± SD (n = 5). *P < 0.05, **P < 0.01, ***P < 0.005
Table 3. Composition (%wt) of the surface of the healing abutment analyzed with EDS. Mean of 5 samples was presented
Groups
Charges and currents
Titanium
Carbon
Others
I
+ 0.5 A
24.77
75.23
-
− 0.5 A
35.13
64.87
-
+ 1 A
62.82
37.18
-
− 1 A
84.10
15.90
-
+ 1.5 A
63.86
36.14
-
− 1.5 A
81.71
18.29
-
II
...
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Mean roughness score of 4 SEM images per electrolysis of different charges and currents
Mean all examiners
P value compared to Control
Ex 1
Ex 2
Ex 3
Control
2.00 ± 0.00
2.00 ± 0.00
2.00 ± 0.00
2.00 ± 0.00
-
− 1 A, group I
4.00 ± 0.00
3.00 ± 0.00
3.25 ± 0.50
3.42 ± 0.17
*
− 1.5 A, group I
4.00 ± 0.00
3.75 ± 0.50
4.00 ± 0.00
...
Table 1 pH after electrolysis. pH was measured after electrolysis for 5 min under different charges and current at constant 10 V. pH of original electrolyte, 7.5% NaHCO3, before electrolysis was 7.8
Charges and currents
Group I
Group II
Group III
−, 0.5 A
7.91
7.92
7.94
+, 0.5 A
7.02
7.03
7.02
−, 1 A
7.94
8.02
8.01
+, 1 A
6.6
6.2
7.72
...
Although EDS analysis was performed in three areas on each sample, the atomic percentage of carbon on the contaminated area was higher than that on the clean area and the atomic percentage of titanium was lower on the contaminated areas than on the clean area except cathodic potential 1 A and 1.5 A in group III. The possible sources of carbon conta...
According to the previous studies, complete killing of bacteria was seen at anode with low current. However, in this study, complete removal of contaminant was seen in electrolysis after cathodic potential 1 A and 1.5 A in group III. This complete removing action can be attributed to the alkaline environment generated at cathodic potential. Moreover, decrease in electro...
However, copper deposition was formed on the sample after electrolysis of anodic potential in group II. It is believed that anodic current was preferentially supplied by the electrolysis of water, which occurred on the surface of the sample because deposition attained electroconductivity. Thus, it was confirmed that copper could be incorporated into the titanium surface sample, t...
Previous studies also pointed out that low direct current can kill oral bacteria forming in biofilm. Although charging the implant surface with current can kill the bacteria, organic residues still remain adhering on the surface. Infected implants present carbon-based contaminants and considerable changes in titanium surfaces composition even after sterilization. This could be the reas...
Therefore, in this study, phloxine B staining was used to detect residual contamination on the surface of the healing abutments.
Previous studies also pointed out that low direct current can kill oral bacteria forming in biofilm. Although charging the implant surface with current can kill the bacteria, organic residues still remain adhering on the surface. Infected implants present carbon-based c...
Discussion
The current study showed that electrolysis could be an effective means to decontaminate the healing abutment surfaces with complete removal of contaminants without any surface changes at 10 V, 1 A into 5 min, cathodic potential in group III. A minimally invasive approach to remove and disinfect dental implants utilizes the fact that titanium is an electrically conducting me...
Analysis of healing abutment surface roughness after electrolysis
Representative SEM images after electrolysis of two different charges (cathodic and anodic) and two different currents (1 A and 1.5 A) are presented in Fig. 3. The SEM images showed surface modification ranging from smoothening to roughening. The surfaces were between the electrolytic healing abutments and control unused healin...
Results
Analysis of the electrolytes’ pH before and after electrolysis
As shown in Table 1, pH of electrolyte (catholyte) was not changed after electrolysis of different currents. However, the pH decreased after electrolysis of anodic potential of 1 A and 1.5 A in group I and II.
Evaluation of the amount of stained area (contamination) of the healing abutments
The perce...
Ninety healing abutments removed from patients at the Dental Implant Clinic, Dental Hospital, Tokyo Medical and Dental University, were used. As this clinical study is an in vitro experimental study, the university ethical committee decided that ethical approval was not necessary.
These healing abutments were at least for 4 weeks up to 6 weeks in patients’ oral cavities. All the healing abu...
Background
A healing abutment is a small metal cap placed on the dental implant. In dental implant treatment, a healing abutment is first placed on the implant. The top of the healing abutment is exposed in the oral cavity, while its body penetrates the soft mucosal tissue. During the implant treatment, the healing abutment is temporarily removed and replaced into several times until the prosth...
Abstract
Background
To evaluate the effects of electrolysis on cleaning the contaminated healing abutment surface and to detect the optimal condition for cleaning the contaminated healing abutment.
Methods
Ninety healing abutments removed from patients were placed in 1% sodium dodecyl sulfate solution and randomly divided for electrolysis with 7.5% sodium bicarbonate in the following three d...
Simpulan
Sekrup penyangga (abutment) yang pecah pada mahkota gigi yang didukung oleh implant endosseous merupakan komplikasi yang tidak menyenangkan. Pecahan yang tertahan dalam piranti dapat diambil dengan bor festooned berlubang # 557 berkecepatan lambat yang disetel dengan torsi terbalik. Begitu fragmen dilonggarkan dan maju pada arah koronal, bor #33 1/3 yang diputar searah jarum jam di...
Wedharan
Komplikasi lumrah dari prostetik implant adalah komplikasi dengan komponennya. Sekrup penyangga menghubungkan bagian abutment ke piranti dan dapat patah karena beban fungsional oklusal.
Ketika menyiapkan perawatan pasien penderita fraktur sekrup penyangga, dokter harus mengambil radiografi untuk memastikan kualitas dukungan tulang pendukung implant. Lubang sekrup piranti harus disiram...
Pendahuluan
Implant gigi telah menjadi modalitas pemaju kehidupan bagi pasien ompong sebagian dan ompong total. Implant bisa sukses mendukung mahkota tunggal yang disemen atau ditahan dengan sekrup. Namun, modalitas ini bukan tanpa komplikasi: Sekrup penyangga bisa patah ketika prostesis berada di bawah pembebanan siklik fungsional. Sekrup penyangga bisa saja kelebihan beban dan patah, meninggalk...
Conclusions
A fractured abutment screw of a crown supported by an endosseous implant is an unhappy complication. The fragment retained in the fixture can be retrieved with a festooned #557 latch slow-speed burr set in reverse torque. Once the fragment is loosened and advanced coronally, a clockwise-turning #33 1/3 burr is touched to the fragment side to completely remove it. Care is taken n...
Discussion
A common complication of implant prosthetics is with components. The abutment screw connects the abutment to the fixture and can fracture under occlusal functional load.
In preparation for treatment of a patient presenting with an abutment screw fracture, a radiograph should be taken to ensure osseous support quality of the supporting implant. The fixture screw hole should be flush...
Introduction
Dental implants have been a life-enhancing modality for partially and completely edentulous patients. Implants can successfully support a cemented or screw-retained single crown. However, this modality is not without complications: A fractured abutment screw may occur when the prosthesis is under functional cyclic loading. The abutment screw may be overloaded and fracture, leaving th...