J Korean Acad Prosthodont.  2008 Dec;46(6):561-568.

The assessment of abutment screw stability between the external and internal hexagonal joint under cyclic loading

Affiliations
  • 1Department of Prosthodontics, Graduate School, Seoul National University, Korea. proshan@unitel.co.kr

Abstract

STATEMENT OF PROBLEM: Currently, many implant systems are developed and divided into two types according to their joint connection: external or internal connection. Regardless of the connection type, screw loosening is the biggest problem in implant-supported restoration. PURPOSE: The purpose of this study is to assess the difference in stability of abutment screws between the external and internal hexagonal connection types under cyclic loading. MATERIAL AND METHODS: Each of the 15 samples of external implants and internal abutments were tightened to 30 N/cm with a digital torque gauge, and cemented with a hemispherical metal cap. Each unit was then mounted in a 30degrees. inclined jig. Then each group was divided into 2 sub-groups based on different periods of cyclic loading with the loading machine (30 N/ cm - 300 N/cm,14 Hz: first group 1 x 10(6), 5 x 10(6) cyclic loading; second group 3 x 10(6), 3 x 10(6) for a total cyclic loading of 6 x 10(6) The removal torque value of the screw before and after cyclic loading was checked. SPSS statistical software for Windows was used for statistical analysis. Group means were calculated and compared by ANOVA, independent t-test, and paired t-test with alpha = 0.05.
RESULTS
In the external hexagonal connection, the difference between the removal torque value of the abutment screw before loading, the value after 1 x 10(6) cyclic loading, and the value after 1 x 10(6), and additional 5 x 10(6) cyclic loading was not significant. The difference between the removal torque value after 3 x 10(6) cyclic loading and after 3 x 10(6), and additional 3 x 10(6) cyclic loading was not significant. In the internal hexagonal connection, the difference between the removal torque value before loading and the value after 1 x 10(6) cyclic loading was not significant, but the value after 1 x 10(6), and additional 5 x 10(6) cyclic loading was reduced and the difference was significant (P < .05). In addition, in the internal hexagonal connection, the difference between the removal torque value after 3 x 10(6) cyclic loading and the value after 3 x 10(6), and additional 3 x 10(6) cyclic loading was not significant.
CONCLUSION
The external hexagonalconnection was more stable than the internal hexagonal connection after 1 x 10(6), and additional 5 x 10(6) cyclic loading (t = 10.834, P < .001). There was no significant difference between the two systems after 3 x 10(6), and additional 3 x 10(6) cycles.

Keyword

Screw loosening; External hexagonal connection; Internal hexagonal connection; Cyclic loading

MeSH Terms

Joints
Torque

Figure

  • Fig. 1. The specially customized metal cap; hemisphere shape in order to transmit the applied load to the center of abutment.

  • Fig. 2. Digital torque gauge (MGT12.mark-10. corp. USA). All abutment screws were tightened to 30 N/cm ± 0.5 N/cm with this digital torque gauge and the removal torque values of the screws were recorded.

  • Fig. 3. Schematic diagram of the specimen. The load was applied on the hemispheric metal cap at 30° and the distance was 11 mm from the exposed position of the fixture to the center of the hemisphere.

  • Fig. 4. The specimen is mounted in the customized jig with 30° inclined plane to be loaded with load machine (Instron model 8871. USA).

  • Fig. 5. Group A, B Group A: External hexagonal connection of the abutment and fixture (Left). Group B: Internal hexagonal connection of the abutment and fixture (Right).


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