Comparing Torque Loss in Standard Implants and Short Implants with Increased Vertical Cantilever Abutments: an In Vitro Study
Objectives: With regard to the prevalence of abutment screw loosening (SL) and bone height reduction, particularly in the posterior regions of the jaws, as well as the contradictory issue of applying short implants instead of surgeries, along with all preparations associated with longer implants, the present study aimed to compare the amount of torque loss in short implants with increased vertical cantilever abutments and standard ones. Material and Methods: In this experimental study, a total number of 20 implants (MegaGen Implant Co., Ltd, South Korea) with 4.5 mm diameter including 10 short implants (7 mm) and 10 standard ones (10 mm) were utilized. Using a surveyor, fixtures were perpendicularly mounted in 13×34 mm resin for short implants and 19×34 mm resin for standard ones. The abutments of the same height but different cuff heights (2.5 mm for the standard implants and 5.5 mm for the short ones) were then tightened with 30 N.cm, via a digital torque meter. To compensate the settling effect, the abutment screw was re-tightened with 30 N.cm after 10 min. Upon applying 500,000 cycles at 75 N.cm and 1 Hz along the longitudinal axis on each sample, blind reverse torque value (RTV) was measured with a digital torque meter. The data were finally analyzed using Student’s t-test. Results: Both groups experienced torque loss, but there was no statistically significant difference between the case and control groups in terms of abutment SL (p = 0451). Conclusion: Short implants seem to be a good mechanical alternative in emergencies with respect to torque loss and abutment SL.
Reverse torque value; Cyclic loading, Short implant; Screw loosening; Crown-implant ratio; Torque loss.
Woong-Rae Cho, Yoon-Hyuk Huh, Chan-Jin Park, and Lee-Ra Cho. Effect of cyclic loading and retightening on reverse torque value in external and internal implants. J Adv Prosthodont 2015 Aug; 7(4): 288–293.
Karthikeyan, Shrikar R. Desai, and Rika Singh. Short implants: A systematic review. J Indian Soc Periodontol 2012 Jul-Sep; 16(3): 302–312.
Sanath Shetty, Naushad Puthukkat, S Vidya Bhat, K Kamalakanth Shenoy. Short implants: A new dimension in rehabilitation of atrophic maxilla and mandible . Journal of Interdisciplinary Dentistry 2014;4:66-70.
Renouard F, Nisand D. Impact of implant length and diameter on survival rates. Clin Oral Implants Res 2006 Oct;17 Suppl 2:35-51.
Emmanuel Panobianco Chizolini, Ana Cláudia Rossi, Alexandre Rodrigues Freire, Felippe Bevilacqua Prado,et al. Short implants in oral rehabilitation 2011 Jul-Sep;8(3):329-334.
Waldemar Reich, Ramona Schweyen, Christian Heinzelmann, Jeremias Hey, Bilal Al-Nawas, Alexander Walter Eckert. Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results. Int J Implant Dent 2017 Dec; 3: 46.
Emre Ozylmaz, Halil Aykul, Eda Ozylmaz, Mehmet Dalkiz. Comparison of short dental implants under different loading conditions and locations. Journal of Engineering Sciences and Design.2014.
Piattelli A, Scarano A, Paolantonio M, et al. Fluids and microbial penetration in the internal part of cement-retained versus screw-retained implant-abutment connections.J Periodontol 2001 Sep;72:1146-1150.
Hnd Hadi Mohammed, Jin-Han Lee, Ji-Myung Bae, and Hye-Won Cho. Effect of abutment screw length and cyclic loading on removal torque in external and internal hex implants. J Adv Prosthodont 2016 Feb; 8(1): 62–69.
Bayraktar M, Gultekin BA, Yalcin S, Mijiritsky E. Effect of crown to implant ratio and implant dimensions on periimplant stress of splinted implant-supported crowns: a finite element analysis. Implant Dent 2013 Aug;22(4):406-13.
Schneider D, Witt L, Hämmerle CH. Influence of the crown-to-implant length ratio on the clinical performance of implants supporting single crown restorations: a cross-sectional retrospective 5-year investigation. Clin Oral Implants Res 2012 Feb;23(2):169-174.
Blanes RJ. To what extent does the crown-implant ratio affect the survival and complications of implant-supported reconstructions? A systematic review. Clin Oral Implants Res 2009 Sep;20 Suppl 4:67-72.
Marcela C. Junqueira; Ricardo F. Ribeiro, et al. Screw loosening of different UCLA-type abutments after mechanical cycling. Braz. J. Oral Sci 2013;12:228-232.
Zeinab Rezaei Esfahrood, Loghman Ahmadi, Elahe Karami, and Shima Asghari. Short dental implants in the posterior maxilla: a review of the literature. J Korean Assoc Oral Maxillofac Surg 2017 Apr; 43(2): 70–76.
Sang-Yun Kim, Jeong-Kui Ku, Hyun-Suk Kim, Pil-Young Yun, and Young-Kyun Kim. A retrospective clinical study of single short implants (less than 8 mm) in posterior edentulous areas. J Adv Prosthodont 2018 Jun; 10(3): 191–196.
Jakub Hadzik, Maciej Krawiec, Konstanty Sławecki, Christiane Kunert-Keil, Marzena Dominiak, and Tomasz Gedrange. The Influence of the Crown-Implant Ratio on the Crestal Bone Level and Implant Secondary Stability: 36-Month Clinical Study. Biomed Res Int 2018: 4246874.
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.
Misch CE, Steigenga J, Barboza E, Misch-Dietsh F, Cianciola LJ, Kazor C. Short dental implants in posterior partial edentulism: a multicenter retrospective 6-year case series study. J Periodontol 2006; 77: 1340-7.
Levine RA, Ganeles J, Jaffin RA, Clem DS 3rd, Beagle JR, Keller GW. Multicenter retrospective analysis of wide-neck dental implants for single molar replacement. Int J Oral Maxillofac Implants 2007; 22: 736 -42.
Ten Bruggenkate CM, Asikainen P, Foitzik C, Krekeler G, Sutter F. Short (6 mm) nonsubmerged dental implants: results of amulticenter clinical trial of 1 to 7 years. Int J Oral Maxillofac Implants 1998; 13: 791-8.
Weng D, Jacobson Z, Tarnow D, Hürzeler MB, Faehn O, Sanavi F, Barkvoll P, Stach RM. A prospective multicenter clinical trial of 3i machined-surface implants: results after 6 years of follow-up. Int J Oral Maxillofac Implants 2003; 18:417–423.
Telleman G, Raghoebar GM, Vissink A, den Hartog L, Huddleston Slater JJ, Meijer HJ. A systematic review of the prognosis of short (<10 mm) dental implants placed in the partially edentulous patient. J Clin Periodontol 2011; 38:667–676.
Herrmann I, Lekholm U, Holm S, Kultje C. Evaluation of patient and implant characteristics as potential prognostic factors for oral implant failures. Int J Oral Maxillofac Implants 2005; 20:220–230.
Ameen Khraisat, Akihiko Hashimoto, Shuichi Nomura, and Osamu Miyakava, BE. Effect of latral cyclic loading on abutment screw loosening of an external hexagon implant system. J Prosthet Dent 2004; 91 (4): 326-334.