Journal List > J Korean Acad Prosthodont > v.48(1) > 1034645

J Korean Acad Prosthodont. 2010 Jan;48(1):61-68. Korean.
Published online Jan 31, 2010.  https://doi.org/10.4047/jkap.2010.48.1.61
Copyright © 2010 The Korean Academy of Prosthodontics
Biomechanical considerations for the screw of implant prosthesis: A literature review
So-Min Im, DDS,1 Dae-Gon Kim, DDS, MSD,1 Chan-Jin Park, DDS, PhD,1 Min-Sang Cha, DDS, MSD,2 and Lee-Ra Cho, DDS, PhD1
1Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea.
2Gangneung Asan Hospital, Collge of Medicine, University of Ulsan, Gangneung, Korea.

Corresponding Author: Lee-Ra Cho. Department of Prosthodontics, College of Dentistry, Gangneung-Wonju National University, 1, GangneungDaehangno, Gangneung, Gangwon-Do, 210-702, Korea. +82-33-640-3163: Email: lila@gwnu.ac.kr
Received December 21, 2009; Revised January 14, 2010; Accepted January 15, 2010.

Abstract

Purpose

This article attempted to determine the factors affecting the preload and screw loosening.

Methods

Available clinical studies from 1981 to 2008 from the PUBMED that presented screw loosening data and review articles regarding screw joint stability were evaluated. Eleven studies dealing the biomechanical principles of the screw mechanics were reviewed. Moreover, the results of our data were included.

Results

The frequency of screw loosening was consequently reduced due to the advancement in torque tightening with torque wrench, screw material, coating technique for reducing the frictional force, and thread design, etc. If preload in the screw falls below a critical level, joint stability may be compromised, and the screw joint may fail clinically. The types of fatigue failure of screw were divided to adhesive wear, plastic deformation, and screw fracture.

Conclusion

An optimum preload is essential to the success of the implant-abutment complex. To maintain optimum preload, using a torque wrench and re-tightening at recall time were needed.

Keywords: Preload; Screw; Screw loosening; Torque

Figures


Fig. 1
Clinical images and SEM images of fractured screws. Arrow indicates the starting point of crack line.
Click for larger image


Fig. 2
Marginal bone loss around the fractured abutment screw. From first fracture, the other fractures were consequently happened (Fig. 1).
Click for larger image


Fig. 3
Estimation of fatigue life of gold screw; theoretical failure and realistic failure.
Click for larger image


Fig. 4
A, Electronic torque controller; B, Torque limiting device; C, Torque indicating device; D, Contra-angle torque device.
Click for larger image


Fig. 5
Loosening torque of titanium screw at 20 Ncm and 30 Ncm tightening torques.
Click for larger image


Fig. 6
Mechanical tolerance of various implants.

A, Implantium (Dentium, Seoul, Korea); B, Astra (Astratech, Mölndal, Sweden); C, GS (Osstem, Pusan, Korea); D, M implant (Shinhung, Seoul, Korea).

Click for larger image


Fig. 7
Spiralock system of Biohorizon (Detroit Tool Industries, Madison Heights, MI).
Click for larger image


Fig. 8
Schematic diagram of the mechanism of adhesive wear of screws in implant prostheses. (Upper thread indicates much milder state, while lower thread indicates much severe state of wear).
Click for larger image

Tables


Table I
Screw loosening in single implant prosthesis
Click for larger image


Table II
Multiple factors for screw loosening
Click for larger image

References
1. McGlumphy EA, Mendel DA, Holloway JA. Implant screw mechanics. Dent Clin North Am 1998;42:71–89.
2. Jung RE, Pjetursson BE, Glauser R, Zembic A, Zwahlen M, Lang NP. A systematic review of the 5-year survival and complication rates of implant-supported single crowns. Clin Oral Implants Res 2008;19:119–130.
3. Jemt T, Laney WR, Harris D, Henry PJ, Krogh PH Jr, Polizzi G, Zarb GA, Herrmann I. Osseointegrated implants for single tooth replacement: a 1-year report from a multicenter prospective study. Int J Oral Maxillofac Implants 1991;6:29–36.
4. Jemt T, Pettersson P. A 3-year follow-up study on single implant treatment. J Dent 1993;21:203–208.
5. Laney WR, Jemt T, Harris D, Henry PJ, Krogh PH, Polizzi G, Zarb GA, Herrmann I. Osseointegrated implants for single-tooth replacement: progress report from a multicenter prospective study after 3 years. Int J Oral Maxillofac Implants 1994;9:49–54.
6. Henry PJ, Laney WR, Jemt T, Harris D, Krogh PH, Polizzi G, Zarb GA, Herrmann I. Osseointegrated implants for single-tooth replacement: a prospective 5-year multicenter study. Int J Oral Maxillofac Implants 1996;11:450–455.
7. Priest G. Single-tooth implants and their role in preserving remaining teeth: a 10-year survival study. Int J Oral Maxillofac Implants 1999;14:181–188.
8. Lang LA, Kang B, Wang RF, Lang BR. Finite element analysis to determine implant preload. J Prosthet Dent 2003;90:539–546.
9. Patterson EA, Johns RB. Theoretical analysis of the fatigue life of fixture screws in osseointegrated dental implants. Int J Oral Maxillofac Implants 1992;7:26–33.
10. Jaarda MJ, Razzoog ME, Gratton DG. Effect of preload torque on the ultimate tensile strength of implant prosthetic retaining screws. Implant Dent 1994;3:17–21.
11. Mitrani R, Nicholls JI, Phillips KM, Ma T. Accuracy of electronic implant torque controllers following time in clinical service. Int J Oral Maxillofac Implants 2001;16:394–399.
12. Gutierrez J, Nicholls JI, Libman WJ, Butson TJ. Accuracy of the implant torque wrench following time in clinical service. Int J Prosthodont 1997;10:562–567.
13. Kim DG, Park CJ, Cho LR. Comparison of accuracy of implant torque controllers. J Kor Acad Stomatognathic Func and Occl 2008;24:157–168.
14. Dellinges M, Curtis D. Effects of infection control procedures on the accuracy of a new mechanical torque wrench system for implant restorations. J Prosthet Dent 1996;75:93–98.
15. Haack JE, Sakaguchi RL, Sun T, Coffey JP. Elongation and preload stress in dental implant abutment screws. Int J Oral Maxillofac Implants 1995;10:529–536.
16. Jörnéus L, Jemt T, Carlsson L. Loads and designs of screw joints for single crowns supported by osseointegrated implants. Int J Oral Maxillofac Implants 1992;7:353–359.
17. Theoharidou A, Petridis HP, Tzannas K, Garefis P. Abutment screw loosening in single-implant restorations: a systematic review. Int J Oral Maxillofac Implants 2008;23:681–690.
18. Kang YM, Lim JH, Cho IH. A study on the abutment screw looseningof dental implants. J Korean Acad Prosthodont 1996;34:1–14.
19. Al Jabbari YS, Fournelle R, Ziebert G, Toth J, Iacopino AM. Mechanical behavior and failure analysis of prosthetic retaining screws after long-term use in vivo. Part 1: Characterization of adhesive wear and structure of retaining screws. J Prosthodont 2008;17:168–180.
20. Misch CE. The effect of bruxism on treatment planning for dental implants. Dent Today 2002;21:76–81.
21. Khraisat A, Hashimoto A, Nomura S, Miyakawa O. Effect of lateral cyclic loading on abutment screw loosening of an external hexagon implant system. J Prosthet Dent 2004;91:326–334.
22. Lang LA, Wang RF, May KB. The influence of abutment screw tightening on screw joint configuration. J Prosthet Dent 2002;87:74–79.
23. Boggan RS, Strong JT, Misch CE, Bidez MW. Influence of hex geometry and prosthetic table width on static and fatigue strength of dental implants. J Prosthet Dent 1999;82:436–440.
24. Al Jabbari YS, Fournelle R, Ziebert G, Toth J, Iacopino AM. Mechanical behavior and failure analysis of prosthetic retaining screws after long-term use in vivo. Part 1: Characterization of adhesive wear and structure of retaining screws. J Prosthodont 2008;17:168–180.