Evaluation of implant abutment screw head deformation in hexagonal and star designs after successive tightening and loosening.

Background: Tightening and loosening of the prosthetic components of the implant are carried out with various screw designs. This study compared the rate of deformation of the abutment screw in two hexagonal and star screw head designs after consecutive tightening and loosening.

Methods: In this study, two fixtures were mounted vertically in die stone blocks using a surveyor. Then the corresponding abutment (with a diameter of 4.5 mm and a gingival height of 2 mm; Dio-SM and Dio-UF system) was mounted on each fixture. In each fixture, six abutment screws from each manufacturer were used (12 abutment screws in total). The abutment screw head of the Dio-UF system is hexagonal, and the abutment screw head of the Dio-SM system is star-shaped. The samples were examined under a stereomicroscope (Nikon C-DS) at a magnification of×50. The image of each abutment screw head (6 abutment screws in each group) was prepared before the procedural steps and after 5, 10, and 15 times of tightening and loosening with 25-Ncm torque using a stereomicroscope. Then the differences in the surface areas of consecutive specimens (0, 5, 10, and 15 consecutive tightening and loosening rounds) between hexagonal and star-shaped abutment screws were calculated. The study results were reported via descriptive statistical methods (mean±standard deviation). Statistical analysis was performed using SPSS 24, and the significance level was defined at P<0.05.

Results: Increasing the number of tightening and loosening rounds increased the screw head surface area in both hexagonal and star shapes. At all stages, the changes in the star-shaped screw head were greater than in the hexagonal screw. These changes were statistically significant at all stages (P<0.05). In addition, there was a statistically significant difference between the area values and the number of tightening and loosening rounds separately in both screw types (P<0.001). Also, the surface areas of the head of both screws in all tightening and loosening rounds were significantly different (P<0.001).

Conclusion: Increasing the number of tightening and loosening rounds increased the screw head surface area in both hexagonal and star-shaped geometrical forms. Also, the extent of area changes at all stages in star-shaped screw heads was greater than in hexagonal screws.