Influence of Abutment Screw-Tightening Methods on the Screw Joint: Immediate and Long-Term Stability.

IF 1.9 Q2 DENTISTRY, ORAL SURGERY & MEDICINE International Journal of Dentistry Pub Date : 2024-01-16 eCollection Date: 2024-01-01 DOI:10.1155/2024/5768318

Manlin Sun, Yusen Shui, Yuqiang Zhang, Ruiyang Ma, Yuwei Zhao, Hongyu Chen, Ping Yu, Zhi Li, Tingting Wu, Haiyang Yu

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Abstract

Objective: To evaluate the influence of screw-tightening methods on the immediate and long-term stability of dental implant screw joints. Methodology. A total of 150 implants of three different implant systems with different diameters were used in this study. Each group was divided into three subgroups (n = 5), according to the tightening methods (A-tightening with recommended torque and retorque after 10 min; B-tightening with recommended torque, then loosening and immediate retorque; C-tightening with recommended torque only once). The operating time of tightening the assemblies was recorded. Ten minutes later, the immediate removal torque (IRT) (Ncm) was measured. After retightening the assemblies, a dynamic load between 20 and 200 N was applied for 10⁵ cycles, and the postloading removal torque (PRT) (Ncm) was measured. Scanning electron microscopy (SEM) was used to observe the surface topography of the screws.

Results: For different types of implants, the IRTs were 11.92 ± 1.04-34.12 ± 0.36 Ncm for method A, 11.64 ± 0.57-33.96 ± 0.29 Ncm for method B, and 10.30 ± 0.41-31.62 ± 0.52 Ncm for method C, and the IRTs of methods A and B were 6.28%-21.58% higher than that of method C (P ≤ 0.046). The PRTs were 4.08 ± 0.77-29.86 ± 0.65 Ncm for method A, 4.04 ± 0.40-29.60 ± 0.36 Ncm for method B, and 2.98 ± 0.26-26.38 ± 0.59 Ncm for method C, and the PRTs of methods A and B were 11.77%-44.87% higher than that of method C (P ≤ 0.016). The removal torque loss rates of methods A (12.49% ± 0.99%-65.88% ± 4.83%) and B (12.84% ± 0.96%-65.35% ± 1.95%) were 3.04%-7.74% lower than that of method C (16.58% ± 0.56%-71.10% ± 1.58%) (P ≤ 0.017). The operating time of method A was much longer than those of methods B and C (P < 0.001). The structural integrity disruption of the screw thread was observed according to the SEM results in all postloading groups.

Conclusions: Method B (torquing and then loosening and immediate retorquing) increases the screw joint immediate stability by 6.28%-21.58% and the long-term stability by 11.77%-44.87% compared with method C (torquing only once), has comparable screw joint stability compared with method A (retorquing after 10 min), saves time and is recommended in clinical settings.

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基台螺钉拧紧方法对螺钉连接的影响：即刻稳定性和长期稳定性。

目的评估螺钉拧紧方法对种植牙螺钉关节近期和长期稳定性的影响。研究方法。本研究共使用了三种不同直径的种植系统的 150 个种植体。根据拧紧方法（A-用推荐扭矩拧紧，10 分钟后重新拧紧；B-用推荐扭矩拧紧，然后松开并立即重新拧紧；C-仅用推荐扭矩拧紧一次），每组分为三个亚组（n = 5）。记录拧紧组件的操作时间。十分钟后，测量立即拆卸扭矩（IRT）（牛顿厘米）。重新拧紧组件后，施加 20 到 200 牛之间的动态负载 105 个循环，并测量加载后的移除扭矩（PRT）（牛顿厘米）。扫描电子显微镜（SEM）用于观察螺钉的表面形貌：对于不同类型的种植体，方法 A 的 IRTs 为 11.92 ± 1.04-34.12 ± 0.36 Ncm，方法 B 为 11.64 ± 0.57-33.96 ± 0.29 Ncm，方法 C 为 10.30 ± 0.41-31.62 ± 0.52 Ncm，方法 A 和 B 的 IRTs 比方法 C 高 6.28%-21.58%（P ≤ 0.046）。方法 A 的 PRT 为 4.08 ± 0.77-29.86 ± 0.65 Ncm，方法 B 为 4.04 ± 0.40-29.60 ± 0.36 Ncm，方法 C 为 2.98 ± 0.26-26.38 ± 0.59 Ncm，方法 A 和 B 的 PRT 比方法 C 高 11.77%-44.87%（P ≤ 0.016）。方法 A（12.49%±0.99%-65.88%±4.83%）和 B（12.84%±0.96%-65.35%±1.95%）的去除扭矩损失率比方法 C（16.58%±0.56%-71.10%±1.58%）低 3.04%-7.74%（P≤0.017）。方法 A 的操作时间远远长于方法 B 和 C（P < 0.001）。根据扫描电子显微镜（SEM）结果，所有加载后组均观察到螺纹结构完整性破坏：结论：与方法 C（仅扭转一次）相比，方法 B（扭转后松开并立即重新扭转）可将螺钉关节的即时稳定性提高 6.28%-21.58%，将长期稳定性提高 11.77%-44.87%；与方法 A（10 分钟后重新扭转）相比，方法 B 的螺钉关节稳定性相当，而且节省时间，值得临床推荐。

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