Professor Emeritus, New York University, New York City, N.Y.
Private practice, Toronto, Canada.
J Prosthet Dent. 2020 Dec;124(6):716-719. doi: 10.1016/j.prosdent.2019.09.019. Epub 2020 Jan 25.
Recent studies have shown that torque-limiting devices (TLDs) do not meet their torque targets and are affected by factors such as the use of the TLDs and the sterilization processes used.
The purpose of this in vitro study was to investigate the accuracy of TLDs currently in use in the Advance Education Program in Prosthodontics at the New York University College of Dentistry.
Five new and 46 in-use TLDs (Nobel BioCare) from the implant kits of the graduate students were evaluated. One investigator was trained and calibrated before testing and after every 10 evaluations. A 3-jaw chuck was mounted on the center of a cap testing device by using the provided mounting screws. A LOCATOR torque driver was clamped into the chuck, and a torque wrench driver was attached to it. The device was placed on a flat table with direct overhead lighting that allowed the investigator to have a consistent view of the notches on the TLDs. A piece of cardboard was attached to the device to ensure that the investigator could not see the readouts. The blinded researcher inserted the wrench and applied the appropriate torque force at the designated notches while another researcher recorded the results. Two readings were made for each TLD at 15, 35, and 45 Ncm. A 2-way ANOVA and an intraclass correlation coefficient to test for intraclinician reliability were performed by using a statistical software program (α=.05).
Two TLDs were damaged and not tested. The 2-way ANOVA demonstrated no significant difference (P>.05) between graduate students in year 1, 2, and 3 or between the autoclaved and new TLDs. The intraclass correlation coefficient was 0.861 for 15 Ncm, 0.589 for 35 Ncm, and 0.764 for 45 Ncm.
In this in vitro study, new and used TLDs all met the recommended torque values. No significant differences were found among groups, suggesting that autoclaving and use did not affect the accuracy of the TLDs tested.
最近的研究表明，扭矩限制装置（TLDs）无法达到其扭矩目标，并且受到 TLDs 的使用以及所使用的灭菌过程等因素的影响。
本体外研究的目的是调查目前在纽约大学牙科学院修复学高级教育计划中使用的 TLD 的准确性。
评估了来自研究生植入套件的 5 个新 TLD 和 46 个在用 TLD（诺贝尔生物护理）。一名调查员在测试前和每 10 次评估后接受培训和校准。使用提供的安装螺钉将三爪夹安装在帽测试装置的中心。将 LOCATOR 扭矩驱动器夹入夹头，然后将扭矩扳手驱动器连接到它。将设备放置在带有直接头顶照明的平坦桌子上，使调查员能够始终如一地看到 TLD 上的凹口。将一块纸板附在设备上，以确保调查员无法看到读数。盲法研究人员插入扳手并在指定凹口施加适当的扭矩力，而另一名研究人员记录结果。每个 TLD 在 15、35 和 45 Ncm 处进行两次读数。使用统计软件程序（α=.05）进行 2 因素方差分析和组内相关系数以测试组内可靠性。
有两个 TLD 损坏未进行测试。2 因素方差分析表明，一年级、二年级和三年级的研究生之间或经过高压灭菌和新 TLD 之间没有显著差异（P>.05）。15 Ncm 的组内相关系数为 0.861，35 Ncm 的组内相关系数为 0.589，45 Ncm 的组内相关系数为 0.764。
在这项体外研究中，新的和使用过的 TLD 都符合推荐的扭矩值。组间未发现显著差异，表明高压灭菌和使用未影响测试的 TLD 的准确性。
