Abstract
Background: Gap at the implant-healing abutment junction can increase the risk of bacterial proliferation. In this study, we determined the leakage at the microgap, and we evaluated hand screwing among clinicians.
Materials and methods: The torques tested with nitrogen gas flow were 10, 15, 20, and 30 N cm, and 54 clinicians were asked to torque down a healing abutment as for a surgical procedure.
Results: There were no significant differences between 10 and 15 N cm, with a total lack of tightness. For 20 and 30 N cm, there was a notable decrease in leakage. The torque achieved by hand was <10 N cm for 61.7% of the clinicians, between 10 and 15 N cm for 29.1%, between 15 and 20 N cm for 8.0%, and between 20 and 25 N cm for 1.2%.
Conclusion: There was a significant difference related to the strength of tightening. Under the conditions of our experiment, the gap of connection was reduced with a torque of ≥20 N cm. Only a small portion of the clinicians could obtain these values by hand. Therefore, a dynamometrical manual wrench should be used to minimize the gap during the osseointegration period.
References
[1] Bernard JP, Belser UC, Martinet JP, Borgis SA. Osseointegration of Brånemark fixtures using a single-step operating technique. A preliminary prospective one-year study in the edentulous mandible. Clin Oral Implants Res 1995; 6: 122–129.10.1034/j.1600-0501.1995.060208.xSearch in Google Scholar PubMed
[2] Boioli LT, Penaud J, Miller N. A meta-analytic, quantitative assessment of osseointegration establishment and evolution of submerged and non-submerged endosseous titanium oral implants. Clin Oral Implants Res 2001; 12: 579–588.10.1034/j.1600-0501.2001.120605.xSearch in Google Scholar PubMed
[3] Brånemark PI, Breine U, Adell R, Hansson BÖ, Lindström J, Olsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg 1969; 3: 81–100.Search in Google Scholar
[4] Broggini N, McManus LM, Hermann JS, et al. Persistent acute inflammation at the implant-abutment interface. J Dent Res 2003; 82: 232–237.10.1177/154405910308200316Search in Google Scholar PubMed
[5] Broggini N, McManus LM, Hermann JS, Medina R, Schenk RK, Buser D. Peri-implant inflammation defined by the implant-abutment interface. J Dent Res 2006; 85: 473–478.10.1177/154405910608500515Search in Google Scholar PubMed
[6] Buser D, Weber HP, Brägger U. The treatment of partially edentulous patients with ITI hollow-screw implants: presurgical evaluation and surgical procedures. Int J Oral Maxillofac Implants 1990; 5: 165–175.Search in Google Scholar
[7] Cecchinato D, Olsson C, Lindhe J. Submerged or non-submerged healing of endosseous implants to be used in the rehabilitation of partially dentate patients. J Clin Periodontol 2004; 31: 299–308.10.1111/j.1600-051X.2004.00527.xSearch in Google Scholar PubMed
[8] Coelho PG, Sudack P, Suzuki M, Kurtz KS, Romanos GE, Silva NR. In vitro evaluation of the implant abutment connection sealing capability of different implant systems. J Oral Rehabil 2008; 35: 917–924.10.1111/j.1365-2842.2008.01886.xSearch in Google Scholar PubMed
[9] Collaert B, de Bruyn H. Comparison of Branemark fixture integration and short-term survival using one-stage or two-stage surgery in completely and partially edentulous mandibles. Clin Oral Implants Res 1998; 9: 131–135.10.1034/j.1600-0501.1998.090209.xSearch in Google Scholar PubMed
[10] Covani U, Marconcini S, Crespi R, Barone A. Bacterial plaque colonization around dental implant surfaces. Implant Dent 2006; 15: 298–304.10.1097/01.id.0000226823.58425.19Search in Google Scholar PubMed
[11] Editorial Board of the Journal of Endodontics. Wanted: a base of evidence. J Endod 2007; 33: 1401–1402.10.1016/j.joen.2007.09.004Search in Google Scholar PubMed
[12] Ericsson I, Randow K, Glantz PO, Lindhe J, Nilner K. Clinical and radiographical features of submerged and nonsubmerged titanium implants. Clin Oral Implants Res 1994; 5: 185–189.10.1034/j.1600-0501.1994.050310.xSearch in Google Scholar PubMed
[13] Ericsson I, Randow K, Nilner K, Peterson A. Some clinical and radiographical features of submerged and non-submerged titanium implants. A 5-year follow-up study. Clin Oral Implants Res 1997; 8: 422–426.10.1034/j.1600-0501.1997.080509.xSearch in Google Scholar
[14] Esposito M, Hirsch JM, Lekholm, U, Thomsen P. Biological factors contributing to failures of osseointegrated implants. (1). Success criteria and epidemiology. Eur J Oral Sci 1998; 106: 527–551.10.1046/j.0909-8836..t01-2-.xSearch in Google Scholar
[15] Esposito M, Grusovin MG, Chew YS, Coulthard P, Worthington HV. One-stage versus two-stage implant placement. A Cochrane systematic review of randomised controlled clinical trials. Eur J Oral Implantol 2009; 2: 91–99.Search in Google Scholar
[16] Fauroux MA, Levallois B, Yachouh J, Cuisinier FJ. Assessment of leakage at the implant-abutment connection using a new gas flow method. Int J Oral Maxillofac Implants 2012; 27: 1409–1412.Search in Google Scholar
[17] Friberg B, Henningsson C, Jemt T. Rehabilitation of edentulous mandibles by means of turned Brånemark system implants after one-stage surgery: a 1-year retrospective study of 152 patients. Clin Implant Dent Relat Res 2005; 7: 1–9.10.1111/j.1708-8208.2005.tb00040.xSearch in Google Scholar
[18] Goheen KL, Vermilyea SG, Vossoughi J, Agar JR. Torque generated by handheld screwdrivers and mechanical torquing devices for osseointegrated implants. Int J Oral Maxillofac Implants 1994; 9: 149–155.Search in Google Scholar
[19] Harder S, Dimaczek B, Acil Y, Terheyden H, Freitag-Wolf S, Kern M. Molecular leakage at implant-abutment connection: in vitro investigation of tightness of internal conical implant-abutment connections against endotoxin penetration. Clin Oral Investig 2010; 14: 427–432.10.1007/s00784-009-0317-xSearch in Google Scholar
[20] Hill EE, Phillips SM, Breeding LC. Implant abutment screw torque generated by general dentists using a hand driver in a limited access space simulating the mouth. J Oral Implantol 2007; 33: 277–279.10.1563/1548-1336(2007)33[277:IASTGB]2.0.CO;2Search in Google Scholar
[21] Kanawati A, Richards MW, Becker JJ, Monaco NE. Measurement of clinicians’ ability to hand torque dental implant components. J Oral Implantol 2009; 35: 185–188.10.1563/1548-1336-35.4.185Search in Google Scholar
[22] Kano SC, Binon PP, Curtis DA. A classification system to measure the implant-abutment microgap. Int J Oral Maxillofac Implants 2007; 22: 879–885.Search in Google Scholar
[23] Persson LG, Lekholm U, Leonhardt A, Dahlen G, Lindhe J. Bacterial colonization on internal surfaces of Branemark system implant components. Clin Oral Implants Res 1996; 7: 90–95.10.1034/j.1600-0501.1996.070201.xSearch in Google Scholar
[24] Romieu OJ, Jacquot B, Callas-Etienne S, Dutilleul PY, Levallois B, Cuisinier FJ. Gas permeability: a new quantitative method to assess endodontic leakage. Biomed. Eng.-Biomed. Tech. 2008; 53: 181–184.Search in Google Scholar
[25] Romieu OJ, Zimanyi L, Warszynski P, et al. Modeling colorant leakage techniques: application to endodontics. Dent Mater 2010; 26: 881–890.10.1016/j.dental.2010.05.003Search in Google Scholar
[26] Rompen E, Domken O, Degidi M, Pontes AE, Piattelli A. The effect of material characteristics, of surface topography and of implant components and connections on soft tissue integration: a literature review. Clin Oral Implants Res 2006; 2: 55–67.10.1111/j.1600-0501.2006.01367.xSearch in Google Scholar
[27] Schroeder A, van der Zypen E, Stich H, Sutter F. The reactions of bone, connective tissue and epithelium to endosteal implants with titanium sprayed surfaces. J Maxillofac Surg 1981; 9: 15–25.10.1016/S0301-0503(81)80007-0Search in Google Scholar
[28] Steinebrunner L, Wolfart S, Bossmann K, Kern M. In vitro evaluation of bacterial leakage along the implant-abutment interface of different implant systems. Int J Oral Maxillofac Implants 2005; 20: 875–881.Search in Google Scholar
[29] Torres JH, Mechali M, Romieu O, et al. Development of a new quantitative gas permeability method for dental implant-abutment connection tightness assessment. Biomed Eng Online 2011; 10: 28.10.1186/1475-925X-10-28Search in Google Scholar PubMed PubMed Central
[30] Weber HP, Buser D, Donath K, et al. Comparison of healed tissues adjacent to submerged and non-submerged unloaded titanium dental implants. A histometric study in beagle dogs. Clin Oral Implants Res 1996; 7: 11–19.10.1034/j.1600-0501.1996.070102.xSearch in Google Scholar PubMed
©2014 by De Gruyter
Articles in the same Issue
- Frontmatter
- Research articles
- Analysis of emboli and blood flow in the ophthalmic artery to understand retinal artery occlusion
- Material properties in unconfined compression of gelatin hydrogel for skin tissue engineering applications
- Red light as a 12-oxo-leukotriene B4 antagonist: an explanation for the efficacy of intensive red light in the therapy of peripheral inflammatory diseases
- Tightening of healing abutments: influence of torque on bacterial proliferation risk, an in vitro investigation
- Influence of superstructure geometry on the mechanical behavior of zirconia implant abutments: a finite element analysis
- Biomechanical investigations of the secondary stability of commercial short dental implants in porcine ribs
- Automatic camera-based identification and 3-D reconstruction of electrode positions in electrocardiographic imaging
- An automatic saccadic eye movement detection in an optokinetic nystagmus signal
- Case Report
- Monitoring of lobectomy in cystic fibrosis with electrical impedance tomography – a new diagnostic tool
- Letters to the Editor
- Accelerometer-based goniometer for smartphone and manual measurement on photographs: do they agree?
- Reply to: Accelerometer-based goniometer for smartphone and manual measurement on photographs: do they agree?
Articles in the same Issue
- Frontmatter
- Research articles
- Analysis of emboli and blood flow in the ophthalmic artery to understand retinal artery occlusion
- Material properties in unconfined compression of gelatin hydrogel for skin tissue engineering applications
- Red light as a 12-oxo-leukotriene B4 antagonist: an explanation for the efficacy of intensive red light in the therapy of peripheral inflammatory diseases
- Tightening of healing abutments: influence of torque on bacterial proliferation risk, an in vitro investigation
- Influence of superstructure geometry on the mechanical behavior of zirconia implant abutments: a finite element analysis
- Biomechanical investigations of the secondary stability of commercial short dental implants in porcine ribs
- Automatic camera-based identification and 3-D reconstruction of electrode positions in electrocardiographic imaging
- An automatic saccadic eye movement detection in an optokinetic nystagmus signal
- Case Report
- Monitoring of lobectomy in cystic fibrosis with electrical impedance tomography – a new diagnostic tool
- Letters to the Editor
- Accelerometer-based goniometer for smartphone and manual measurement on photographs: do they agree?
- Reply to: Accelerometer-based goniometer for smartphone and manual measurement on photographs: do they agree?