Citation Information :
Jongsiri S, Arksornnukit M, Homsiang W, Kamonkhantikul K. Effect of Restoration Design on the Removal Torque Loss of Implant-supported Crowns after Cyclic Loading. J Contemp Dent Pract 2023; 24 (12):951-956.
Aim: To compare the removal torque loss (RTL) percentage of screw-retained, cement-retained, and combined screw- and cement-retained implant-supported crowns after cyclic loading and measure the impact of cyclic loading on removal torque.
Materials and methods: Thirty-two dental implants (4.0 × 10 mm) in resin blocks and abutments were divided into four groups (n = 8) based on restoration design: combined screw- and cement-retained group (SC), two cement-retained groups: cemented with adhesive resin cement (AR) (Panavia V5) or provisional cement (PR) (RelyX Temp NE), and screw-retained one-piece titanium group (TI). Removal torques were measured in Newton-centimeter (Ncm) before and after 500,000-cycle cyclic loading with forces ranging from 20 to 200 N at 15 Hz. The RTL percentage in each group was calculated. The paired t-test was used to detect the difference between pre-loading (RT1) and post-loading removal torque (RT2) in each group and 1-way ANOVA was used to detect the difference of RTL percentage between groups.
Results: The post-loading removal torques in all groups were significantly lower than their pre-loading removal torques (p < 0.001). The 1-way ANOVA test found no significant difference in the RTL% between the study groups. The PR group exhibited the lower RTL% (30.74 ± 7.3%), followed by the TI (30.78 ± 5.6%), AR (32.12 ± 2.5%), and SC (35.71 ± 5.1%) groups.
Conclusion: Combined screw- and cement-retained restorations exhibited similar RTL compared with other restoration designs, and cyclic loading significantly affected the removal torque.
Clinical significance: Combined screw- and cement-retained restorations can be utilized in single-tooth situations, offering a comparable impact on screw joint stability while providing benefit of retrievability. Cyclic loading significantly influences joint stability, periodic checkup for screw loosening is recommended.
Jung RE, Pjetursson BE, Glauser R, et al. A systematic review of the 5-year survival and complication rates of implant-supported single crowns. Clin Oral Implants Res 2008;19(2):119–130. DOI: 10.1111/j.1600-0501.2007.01453.x.
Chee W, Felton DA, Johnson PF, et al. Cemented versus screw-retained implant prostheses: which is better? Int J Oral Maxillofac Implants 1999;14(1):137–141. PMID: 10074764.
Michalakis KX, Hirayama H, Garefis PD. Cement-retained versus screw-retained implant restorations: A critical review. Int J Oral Maxillofac Implants 2003;18(5):719–728. PMID: 4579961.
McGlumphy EA, Papazoglou E, Riley RL. The combination implant crown: A cement- and screw-retained restoration. Compendium 1992;13(1):34, 36, 38 passim. PMID: 1521259.
Sarafidou K, Vasileiadi G, Louvrou MK, et al. Screwmentable implant-supported prostheses: A systematic review. J Prosthet Dent 2023;130(1):35–47. DOI: 10.1016/j.prosdent.2021.08.027.
Wadhwani CPK, Schwedhelm ER, Tarica DY, et al. Implant luting cements. In: Wadhwani CPK, editor. Cementation in Dental Implantology: An Evidence-Based Guide. Berlin, Heidelberg: Springer; 2015. pp. 50–51.
Breeding LC, Dixon DL, Bogacki MT, et al. Use of luting agents with an implant system: Part I. J Prosthet Dent 1992;68(5):737–741. PMID: 1432793.
Nematollahi F, Beyabanaki E, Alikhasi M. Cement selection for cement-retained implant-supported prostheses: A literature review. J Prosthodont 2016;25(7):599–606. DOI: 10.1111/jopr.12361.
Mehl C, Harder S, Wolfart M, et al. Retrievability of implant-retained crowns following cementation. Clin Oral Implants Res 2008;19(12):1304–1311. DOI: 10.1111/j.1600-0501.2008.01587.x.
Rosentritt M, Schneider-Feyrer S, Behr M, et al. In vitro shock absorption tests on implant-supported crowns: Influence of crown materials and luting agents. Int J Oral Maxillofac Implants 2018;33(1):116–122. DOI: 10.11607/jomi.5463.
Nejatidanesh F, Shakibamehr AH, Savabi O. Comparison of marginal and internal adaptation of CAD/CAM and conventional cement retained implant-supported single crowns. Implant Dent 2016;25(1):103–108. DOI: 10.1097/ID.0000000000000346.
Denry I, Kelly JR. State of the art of zirconia for dental applications. Dent Mater 2008;24(3):299–307. PMID: 17659331.
McGlumphy EA, Mendel DA, Holloway JA. Implant screw mechanics. Dent Clin North Am 1998;42(1):71–89. PMID: 9421671.
Jo JY, Yang DS, Huh JB, et al. Influence of abutment materials on the implant-abutment joint stability in internal conical connection type implant systems. J Adv Prosthodont 2014;6(6):491–497. DOI: 10.4047/jap.2014.6.6.491.
Winkler S, Ring K, Ring JD, et al. Implant screw mechanics and the settling effect: Overview. J Oral Implantol 2003;29(5):242–245. PMID: 14620687.
Wittneben JG, Buser D, Salvi GE, et al. Complication and failure rates with implant-supported fixed dental prostheses and single crowns: a 10-year retrospective study. Clin Implant Dent Relat Res 2014;16(3):356–364. DOI: 10.1111/cid.12066.
Sailer I, Mühlemann S, Zwahlen M, et al. Cemented and screw-retained implant reconstructions: A systematic review of the survival and complication rates. Clin Oral Implants Res 2012;23(Suppl 6):163–201. DOI: 10.1111/j.1600-0501.2012.02538.x.
Moris IC, Faria AC, Ribeiro RF, et al. Torque loss of different abutment sizes before and after cyclic loading. Int J Oral Maxillofac Implants 2015;30(6):1256–1261. DOI: 10.11607/jomi.3868.
Vahey BR, Sordi MB, Stanley K, et al. Mechanical integrity of cement- and screw-retained zirconium-lithium silicate glass-ceramic crowns to Morse taper implants. J Prosthet Dent 2018;120(5):721–731. DOI: 10.1016/j.prosdent.2018.01.028.
Hussien AN, Rayyan MM, Sayed NM, et al. Effect of screw-access channels on the fracture resistance of 3 types of ceramic implant-supported crowns. J Prosthet Dent 2016;116(2):214–220. DOI: 10.1016/j.prosdent.2015.12.016.
Rosa L, Borba M, Mallmann F, et al. Influences of screw access hole and mechanical cycling on the fracture load of implant-supported crowns. Int J Prosthodont 2019;32(5):423–429. DOI: 10.11607/ijp.6286.
ISO 14801. Dentistry-Implants-Dynamic Fatigue Test for Endosseous Dental Implants. Geneva, Switzerland: International Organization for Standardization; 2016.
Siamos G, Winkler S, Boberick KG. Relationship between implant preload and screw loosening on implant-supported prostheses. J Oral Implantol 2002;28(2):67–73. PMID: 12498448.
Graf H. Bruxism. Dent Clin North Am 1969;13(3):659–665. PMID: 5256151.
Mericske-Stern R, Zarb GA. In vivo measurements of some functional aspects with mandibular fixed prostheses supported by implants. Clin Oral Implants Res 1996;7(2):153–161. DOI: 10.1034/j.1600-0501.1996.070209.x.
Scheid RC. Morphology of Premolars. In: Scheid RC, editor. Woelfel's Dental Anatomy. 8th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2012. pp. 85–119.
Benjaboonyazit K, Chaijareenont P, Khongkhunthian P. Removal torque pattern of a combined cone and octalobule index implant-abutment connection at different cyclic loading: An in-vitro experimental study. Int J Implant Dent 2019;5(1):1. DOI: 10.1186/s40729-018-0154-2.
Huang Y, Wang J. Mechanism of and factors associated with the loosening of the implant abutment screw: A review. J Esthet Restor Dent 2019;31(4):338–345. DOI: 10.1111/jerd.12494.
Sammour SR, Maamoun El-Sheikh M, Aly El-Gendy A. Effect of implant abutment connection designs, and implant diameters on screw loosening before and after cyclic loading: In-vitro study. Dent Mater 2019;35(11):e265–e271. DOI: 10.1016/j.dental.2019.07.026.
Yi Y, Heo SJ, Koak JY, et al. Comparison of CAD/CAM abutment and prefabricated abutment in Morse taper internal type implant after cyclic loading: Axial displacement, removal torque, and tensile removal force. J Adv Prosthodont 2019;11(6):305–312. DOI: 10.4047/jap.2019.11.6.305.
Klongbunjit D, Aunmeungtong W, Khongkhunthian P. Implant-abutment screw removal torque values between customized titanium abutment, straight titanium abutment, and hybrid zirconia abutment after a million cyclic loading: an in vitro comparative study. Int J Implant Dent 2021;7(1):98. DOI: 10.1186/s40729-021-00378-z.
Paek J, Woo YH, Kim HS, et al. Comparative analysis of screw loosening with prefabricated abutments and customized CAD/CAM abutments. Implant Dent 2016;25(6):770–774. DOI: 10.1097/ID.0000000000000481.
Taha D, Sabet A. In vitro evaluation of material dependent force damping behavior of implant-supported restorations using different CAD-CAM materials and luting conditions. J Prosthet Dent 2021;126(1):93.e1–93.e9. DOI: 10.1016/j.prosdent.2021.03.016.