Comparison of reverse torque values of abutment screws with the application of oil-based and water-based antibacterial agents

Influence of toothbrushing methods on tightening torque with healing abutments of different lengths: An in vitro study

STATEMENT OF PROBLEM

Early tightening torque at the implant-healing abutment interface is a recognized concern in implant treatment. However, little is known regarding the effects of toothbrushing methods on the interface established between the implant and healing abutments of different heights.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of different toothbrushing methods on tightening torque for healing abutments of different heights.

MATERIAL AND METHODS

A total of 60 implants (Bilimplant; Proimtech) were embedded in epoxy resin blocks. The following 6 test groups were established: healing abutments with manual toothbrush group (Oral B Pro Expert All in one; Oral B) and 4 mm height (MTB-4, (which served as the control); 6 mm height (MTB-6, which served as the control); sonic toothbrush group (Philips Sonicare 3100 Series; Philips Oral Healthcare) and 4 mm height (S-4); 6 mm height (S-6); oscillating/rotating toothbrush group (Oral B Smart 6 6000N; Oral B) and 4 mm height (OR-4) and 6 mm height (OR-6). Each specimen was tightened to 15 Ncm and brushed. The digital torque meter (Cap Torque Tester Series TT01; Mark10) was used to calculate the reverse torque values.

RESULTS

The highest torque loss value in the average torque losses in the test groups was 1.3 (OR-6); the lowest was 0.3 (S-4). While a significant difference was found between groups S-4 and S-6 (P=.018), no statistically significant difference was found among the other groups (P>.05).

CONCLUSIONS

Torque loss was greater in the healing abutment with a height of 6 mm and with the oscillatory and rotational brushing method.

Effects of Blood Contamination and Decontamination Protocol on Reverse Torque Value of Abutment Screws in Dental Implants: An In Vitro Study

Background and Objective: Loosening of abutment screws in dental implants is a mechanical complication that affects prosthetic treatments and hence, patient satisfaction. Blood contamination of abutment screws may play a role in this phenomenon. However, only limited research attention has been given to this issue. In the present study, we determined the effect of blood contamination and decontamination protocol on the reverse torque value (RTV) of abutment screws. Materials and Methods: A questionnaire-based survey was sent to 210 implantologists requesting feedback on their attitude to the blood contamination issue and the decontamination protocols used. The survey responses were used in a selection of the decontamination solutions that were used in the subsequent in vitro study on the effects of blood decontamination protocol on the RTV of abutment screws. Thus, three study groups were used (n = 20 abutment screws in each group): Group 1 (control group; blood-contaminated screws); Group 2 (screws decontaminated with 5.25% sodium hypochlorite (NaOCl) solution); and Group 3 (screws decontaminated with normal saline solution (0.9%)). Then, each of the connections were subjected to thermocycling, and RTVs of the screw were measured using a digital torque meter. Intragroup and intergroup RTVs were analyzed for significance using analysis of variance (ANOVA) and Tukey's honestly significant difference (HSD) tests. Results: 48% of the implantologists responded to the survey; 80% of them were concerned with blood contamination in the implant connection, especially before abutment loading and 85% of them used either chlorhexidine solution or normal saline solution as the decontamination agent. The mean RTV for Group 2 screws (30.27 ± 2.8 N.cm) was significantly greater than that for Group 3 screws (26.02 ± 1.99 N.cm) which, in turn, was significantly greater than that for Group 1 screws (23.64 ± 1.84 N.cm). Conclusion: Decontamination of blood-covered connections using 5.25% NaOCl solution or normal saline solution restores the RTV of abutment screws. This finding may have clinical relevance in that the decontaminated screws may contribute to the low incidence of screw loosening and, ultimately, improved patient satisfaction.