Arshad Mahnaz, Mahgoli Hosseinali, Payaminia Leila
Int J Oral Maxillofac Implants. 2018 January/February;33(1):31–40. doi: 10.11607/jomi.5476. Epub 2017 Sep 22.
To evaluate the effect of repeated screw joint closing and opening cycles and cyclic loading on abutment screw removal torque and screw thread morphology using scanning electron microscopy (SEM).
Three groups (n = 10 in each group) of implant-abutment-abutment screw assemblies were created. There were also 10 extra abutment screws as new screws in group 3. The abutment screws were tightened to 12 Ncm with an electronic torque meter; then they were removed and removal torque values were recorded. This sequence was repeated 5 times for group 1 and 15 times for groups 2 and 3. The same screws in groups 1 and 2 and the new screws in group 3 were then tightened to 12 Ncm; this was also followed by screw tightening to 30 Ncm and retightening to 30 Ncm 15 minutes later. Removal torque measurements were performed after screws were subjected to cyclic loading (0.5 × 10⁶ cycles; 1 Hz; 75 N). Moreover, the surface topography of one screw from each group before and after cyclic loading was evaluated with SEM and compared with an unused screw.
All groups exhibited reduced removal torque values in comparison to insertion torque in each cycle. However, there was a steady trend of torque loss in each group. A comparison of the last cycle of the groups before loading showed significantly greater torque loss value in the 15th cycle of groups 2 and 3 compared with the fifth cycle of group 1 (P < .05). Nonetheless, torque loss values after loading were not shown to be significantly different from each other.
Using a new screw could not significantly increase the value of removal torque. It was concluded that restricting the amount of screw tightening is more important than replacing the screw with a new one when an abutment is definitively placed.
使用扫描电子显微镜(SEM)评估反复的螺钉关节闭合和打开循环以及循环加载对基台螺钉拆除扭矩和螺纹形态的影响。
创建三组(每组n = 10)种植体-基台-基台螺钉组件。第三组还有10颗额外的基台螺钉作为新螺钉。使用电子扭矩计将基台螺钉拧紧至12 Ncm;然后将其拆除并记录拆除扭矩值。第一组重复此序列5次,第二组和第三组重复15次。然后将第一组和第二组中的相同螺钉以及第三组中的新螺钉拧紧至12 Ncm;之后还将螺钉拧紧至30 Ncm,并在15分钟后再次拧紧至30 Ncm。在螺钉经受循环加载(0.5×10⁶次循环;1 Hz;75 N)后进行拆除扭矩测量。此外,用SEM评估每组一颗螺钉在循环加载前后的表面形貌,并与未使用的螺钉进行比较。
与每个循环中的插入扭矩相比,所有组的拆除扭矩值均降低。然而,每组均存在扭矩损失的稳定趋势。加载前各组最后一个循环的比较显示,第二组和第三组第15个循环的扭矩损失值明显大于第一组第5个循环(P < 0.05)。尽管如此,加载后的扭矩损失值彼此之间无显著差异。
使用新螺钉并不能显著增加拆除扭矩值。得出的结论是,当确定放置基台时,限制螺钉拧紧量比更换新螺钉更重要。