Clinical Implications

Dental Implants

Robert Dobrin, BSME, DMD, is an assistant professor with the department of prosthodontices at the Nova Southeastern University College of Dental Medicine and can be reached at rdobrin@ nova.edu.

References

1. T. Albrektsson, L. Canullo, D. Cochran, H. De Bruyn “Peri-implantitis”: A complication of a foreign body or a human-made “Disease.” Facts and fiction

Clin Implant Dent Relat Res, 18 (2016), pp. 840-849

2. E. Berroeta, I. Zabalegui, T. Donovan, W. Chee

Dynamic abutment: A method of redirecting screw access for implant-supported restorations: Technical details and a clinical report J Prosthet Dent, 113 (2015), pp. 516-519

3. The effect of screwdriver angle variation on the off-axis implant abutment system and hexalobular screw

R Opler, C Wadhwani, KH Chung - The Journal of prosthetic dentistry, Volume 123, Issue 3, March 2020, Pages 524-528

In this example, the retaining screw is being driven 25 degrees off the long axis of the implant. Therefore, the portion of the torque along the long axis of the implant, which creates the clamping force retaining the crown, is the torque applied to the driver times 0.9 (the cosine of 25 degrees). If the torque applied to the driver is 35 Newton Centimeters (NCM), then the torque applied to the screw is only 31.5 NCM. This diminution of torque may or may not lead to clinically significant reduced clamping force of the crown to the implant, but the clinician must be aware that they are applying less torque to the screw. Below are examples of the amount of axial torque that will be applied to the screw when the wrench delivers 35 NCM at various angles from the long axis of the implant.

35 Ncm Reading On Torque Wrench

ANGLE

4. Abutment screw torque changes with straight and angled screw-access channels

RS Swamidass, JYK Kan, MT Kattadiyil… - The Journal of Prosthetic …,Volume 125, Issue 4, April 2021, Pages 675-681

5. J.H. Bickford An introduction to the design and behavior of bolted joints Taylor and Francis Group, Oxford (1995), pp. 175-180

6. R.L. Burguete, R.B. Johns, T. King, E.A. Patterson Tightening characteristics for screwed joints in osseointegrated dental implants

J Prosthet Dent, 71 (1994), pp. 592-599

7. OpenStax University Physics. Authored by: OpenStax CNX. Located at: https://cnx.org/contents/1Q9uMg_a@10.16:Gofkr9Oy@15. License: CC BY: Attribution. License Terms: Download for free at http:// cnx.org/contents/d50f6e32-0fda-46ef-a362-9bd36ca7c97d@10.16

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