J Korean Acad Prosthodont.  2010 Oct;48(4):243-250. 10.4047/jkap.2010.48.4.243.

The effect of screw tightening techniques on the detorque value in internal connection implant superstructure

• Choi JH

• KMID: 2195538
• DOI: http://doi.org/10.4047/jkap.2010.48.4.243

Abstract

PURPOSE
This study evaluated the effect of different screw tightening sequences and methods on detorque values in a well-fitting implant superstructure. MATERIAL AND METHODS: A fully edentulous mandibular master model and a metal framework directly connected to four parallel implants (Astra Tech) with a passive fit to each other were fabricated. Six stone casts were made with a splinted impression technique to represent a 'well-fitting' situation with the metal framework. Detorque values were measured twice after screw tightening using 20 Ncm. Detorque values and minimum detorque values for three screw tightening sequences (1-2-3-4, 2-4-3-1, and 2-3-1-4) and for two tightening methods (two-step and one-step) were analyzed using multi-way analysis of variance and two-way analysis of variance, respectively, at a .05 level of significance.
RESULTS
The mean detorque values for screw tightening sequences ranged from 12.8 Ncm (2-4-3-1) to 13.1 Ncm (2-3-1-4), and for screw tightening methods were 13.1 Ncm (two-step) and 11.8 Ncm (one-step). The mean of mimimum detorque values for screw tightening sequences were 11.1 Ncm (1-2-3-4) and 11.2 Ncm (2-4-3-1 and 2-3-1-4), and for screw tightening methods were 11.2 Ncm (two-step) and 9.9 Ncm (one-step). No statistically significant differences among three screw tightening sequences were found for detorque values and for mimimum detorque values. But, statistically significant differences between two screw tightening methods were found for two values. Two-step screw tightening method showed higher detorque value (P = .0003) and higher minimum detorque value (P = .0035) than one-step method.
CONCLUSION
Within the limitations of this study, the screw tightening sequence was not a critical factor for the detorque values in a well-fitting implant superstructure by the splinted impression technique. But, two-step screw tightening method showed greater detorque values than one-step method.

Keyword

Screw tightening sequence; Screw tightening method; Detorque value; Splinted impression technique; Internal-connection dental implant

MeSH Terms

Splints

Figure

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  Fig. 1. Metal framework simulating a prosthesis that directly connected to four internal-connection implants.

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  Fig. 2. Master model with four internal-connection implant replicas made from a pickup impression of the superstructure to establish a passive fit relationship.

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  Fig. 3. Acrylic resin splints sectioned equidistantly between the impression copings. Fifteen minutes before the impression making, these were reconnected with an incremental application technique to minimize the polymerization shrinkage of the resin.

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  Fig. 4. Measurement of detorque values: Screw driver was carefully oriented in the long axis of the implant during screw tightening and loosening.

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