preload of implant is comparable to what force

Systematic analysis of factors that cause loss of preload in dental implants

Section of Prosthodontics, Adhiparasakthi Dental Higher, Melmaruvathur, Tamil Nadu, India

Date of Submission	16-Oct-2017
Date of Acceptance	28-Mar-2018
Date of Web Publication	05-Jul-2018

Correspondence Accost:
Dr. Southward Nithyapriya
Department of Prosthodontics, Adhiparasakthi Dental College, Melmaruvathur, Tamil Nadu
India

Source of Back up: None, Conflict of Interest: None

DOI: 10.4103/jips.jips_294_17

Spiral loosening is the almost common gene associated with dental implant failure. One of the major crusade for screw loosening is the "loss of preload". Several factors including screw geometry, fabric properties specially stiffness, surface texture and condition of mating surfaces, degree of lubrication, rate of tightening, integrity of joint etc.
Objective: This review analyses the factors that are responsible for the loss of preload.
Material and Methods: Screw geometry, Implant- Abutment Connection blazon (external hexagon platform, morse taper), Material properties viz Stiffness, Resilience, Materials viz gold, titanium, titanium alloy, Surface texture of the abutment spiral, Status of mating surfaces, Lubrication, Torque value, Rate of tightening (ten, 20, 35N and retorque subsequently 10mins) are taken into consideration in this written report. The MEDLINE-PubMed database was searched from September 2016 to 10 years previously. Several journals were manus searched and from cross references. The outcome analysed are the factors that are responsible for loss of preload.
Results: The search yielded 84 articles. Later excluding duplicated abstracts and applying the inclusion and exclusion criteria, 36 studies were eligible for analysis. The result shows that loss of preload can occurs depending upon the type of fabric used, torque method, torque sequences, abutment connection type, influence of lubrication, abutment collar length. Nevertheless we detected some potential limitations in the studies selected, mainly a minimum number of samples used for the study. Hence nosotros advise further studies to guarantee an excellence in methodological quality.
Decision: Based on the bachelor data it can be summarized that the cognition of preload loss must exist known for the clinicians to avoid such screw loosening and subsequent implant failure.

Keywords: Abutment screw, dental implant, preload

How to cite this article:
Nithyapriya Due south, Ramesh A S, Kirubakaran A, Mani J, Raghunathan J. Systematic analysis of factors that cause loss of preload in dental implants. J Indian Prosthodont Soc 2018;18:189-95

How to cite this URL:
Nithyapriya S, Ramesh A S, Kirubakaran A, Mani J, Raghunathan J. Systematic assay of factors that cause loss of preload in dental implants. J Indian Prosthodont Soc [serial online] 2018 [cited 2022 Apr 7];18:189-95. Available from: https://world wide web.j-ips.org/text.asp?2018/18/3/189/234911

Introduction

The most mutual failure associated with dental implant is screw loosening and fracture of implant.^[1] Ane of the major causes for screw loosening is the "loss of preload." Preload is the axial force in the neck of the spiral, which is between the first mating thread and caput of the abutment spiral.^[2] The tensile force clamps the abutment to the implant.^[3] The relationship betwixt applied torque and preload depends on several factors including screw geometry, material properties, surface texture, degree of lubrication, rate of tightening, and integrity of joint.^[two] This study aim at determining the factors which causes loss of preload in dental implants. This systematic review is focused on the factors which cause loss of preload that leads to dental implant failure.^[4],[5],[6]

Methodology

Search strategies

The following analysis was performed co-ordinate to the guidelines and the principles of the PRISMA statement for a systematic review.

Focused question (Patients, Intervention, Comparing, and Outcomes)

The review is focused on: "what are the factors causing loss of preload which eventually leads to dental implant failure?"

The following medical subjects headings terms: "abutment spiral," "preload," "dental implants," and their related entry terms were used in different combinations using the Boolean Operators "AND" and "OR" for the enquiry. In addition, transmission search was made [Figure 2].

([dental implants] AND abutment screw]) AND preload.

Inclusion criteria

Loss of preload, screw loosening, screw fracture, screw geometry, implant-abutment connectedness type (external hexagon platform, Morse taper), fabric properties, namely, stiffness, resilience, and materials, namely, gold, titanium (Ti), Ti blend, surface texture of the abutment screw, condition of mating surfaces, lubrication, torque value, rate of tightening (10, 20, 35N, and retorque afterward ten min), and integrity of articulation.

Exclusion criteria

Functional habits such as bruxism, clinical syndromes (such every bit epilepsy, psychological disorders, and osteoporosis) implant fracture.

Filters

Other inclusion criteria are equally follows (a) articles published in English language linguistic communication; (b) homo studies; (c) studies which have the relationship between dental implants and loss of preload; (d) animal studies; (e) systematic reviews; (f) accomplice studies; and (g) randomized controlled trial (RCT).

Other exclusion criteria are every bit follows (a) articles published in another language other than English; (b) studies that does not take the relation between dental implants and loss of preload; (c) full text articles that were not bachelor on the database searched; (d) duplicated articles; (e) letters to editor; and (f) commentaries. Studies other than RCT, systematic reviews and cohort studies were eliminated to reduce bias.

Information extraction

All studies which met the inclusion and exclusion criteria for review were obtained and screened independently and were analyzed using PRISMA guidelines [Figure 1]. The following data were extracted from the studies included for review reference, study design, number of implants, grouping specification of the report, initial torque, preload, and loss of preload. The quality of the various studies was not considered in the last analysis; therefore, no quality assessment has been done.

Discussion

Preload is the initial load when a torque is applied to the screw. The preload is a contributing factor for the stability of spiral connectedness parts, is affected past various mechanical factors.^[5] One of which is the settling event or embedment relaxation. The settling effect occurs due to microroughness on the two contact surfaces then that when initial torquing of the screw is applied, the rough areas collapse and leads to screw loosening. Hence, preload must be maintained to prevent joints from separating.^{[1],[5],[6],[x]}

The present review is investigated to determine the factors that are responsible for loss of preload and spiral loosening.

Type of Material

Six manufactures, which includes 102 implants the preload values of dissimilar types of materials were evaluated. In comparison between golden, Ti, Ti alloys and surface treated Ti, gilt exhibits higher preload value than other elements. It is and so followed past Ti alloys, surface-treated Ti, and pure Ti type of material [Table 2].^{[14],[sixteen],[28],[31],[37],[38],[twoscore],[41],[42],[44]}

Torque Method

Two articles, compared the efficacy of transmission torque with that of the digital torque meter, out of which one commodity is a systematic review. By the outcome, researchers found that calibrated torquing devices are mandatory as the abutment should not be over tightened or under tightened to avoid misfiting of the implant abutment complex [Tabular array 4].^{[2],[3],[21],[25],[34],[45]}

Torque Sequence

Seven articles evaluated the torquing sequence for the maintenance of preload values and found that retorquing after x min of initial torque is efficient to maintain the preload value [Table 1].^{[1],[half dozen],[12],[18],[23],[27],[thirty],[32],[33],[37],[43]}

Abutment Connectedness Blazon

Of the vii articles, two articles were concluded by doing a study in about 56 implants and found the result that pattern of joint was non meaning in affecting the preload values. And besides, other articles which includes 51 implants, showed that internal hexagon blazon exhibits greater preload than external hexagonal type [Table 3].^{[viii],[eleven],[15],[16],[17],[19],[20],[22],[24],[26]}

Influence of Lubrication

Dry lubricant coatings such as lx–80 nm Ti nanoparticles, Vaseline, and man saliva were used every bit a lubricating agent in about three studies. Lxxx-five implants were evaluated for this influence of lubrication on preload values. Results found that lubricants decreases the friction and thereby helps in maintenance of preload by regulating the settling effect [Tabular array 5].^{[7],[nine],[xiii],[29],[39]}

Abutment Collar Length

Ane article evaluated the significance of abutment collar length in a total of fifteen implants and found that increase in the acme of abutment collar length has a significant influence on the torque loss of abutment-implant spiral after cyclic loading [Table 6].^[35],[36]

Summary

Equally per the results of the studies include nosotros can summarizes the following.

• Gold fixation screws provides higher preload values than Ti and Ti alloy screws
• Calibrated torquing device is mandatory to get adequate preload
• Retorquing of abutment screws subsequently 10 min of the initial torque should exist performed during implant abutment connection
• Abutments with more than extensive contact areas with implant have been associated with a lower incidence of toque loss
• Internal connection blazon has higher preload value than external hexagon blazon
• Results institute that lubricants decreases the friction and thereby helps in maintenance of preload by regulating the settling effect.

Conclusion

Ideally, the use of lubricated gold screws with internal connection type should be placed with calibrated torquing device and retorquing it after 10 min of the initial torque gives the maximum preload. Since screw loosening is the major reason for implant failure due to embedment relaxation, ane should know the reason backside it. The knowledge of preload loss must be known for the clinicians to avoid such screw loosening and subsequent implant failure.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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  [Effigy ane], [Figure two]
  [Table 1], [Table 2], [Tabular array 3], [Table 4], [Table five], [Tabular array 6]

This article has been cited past ane Assessment of Preload Loss after Cyclic Loading in the OT Bridge Organization in an �All-on-4� Rehabilitation Model in the Absence of Ane and Ii Prosthesis Screws Mario Cesare Pozzan, Francesco Grande, Edoardo Mochi Zamperoli, Fabio Tesini, Massimo Carossa, Santo Catapano Materials. 2022; 15(iv): 1582 [Pubmed] | [DOI] ii Comparative Analysis of the Stability of Prosthetic Screws under Cyclic Loading in Implant Prosthodontics: An In Vitro Written report Santo Catapano, Mattia Ferrari, Nicola Mobilio, Marco Montanari, Massimo Corsalini, Francesco Grande Applied Sciences. 2021; eleven(2): 622 [Pubmed] | [DOI] iii Effect of Awarding of a Bio-Adhesive on the Removal Torque Value and Rotational Misfit at the Implant�Abutment Junction: An In Vitro Study Mahnaz Arshad, Sina Khayat Zadeh, Mohammad Atai, Gholamreza Shirani, Georgios East. Romanos, Seyed Hossein Bassir Materials. 2021; 14(22): 6832 [Pubmed] | [DOI] 4 A 3-year prospective cohort written report on mandibular anterior cantilever restorations associated with spiral-retained implant-supported prosthesis: An in vivo study VizaikumarVasudha Nelluri, KandathilparambilMaria Roseme, RajaniKumar Gedela The Journal of Indian Prosthodontic Society. 2021; 21(2): 150 [Pubmed] | [DOI] 5 Evaluation of reverse torque values and failure loads of three dissimilar abutment designs with internal connections Saied Nokar, Habib Hajimiragha, Leyla Sadighpour, AzamSadat Mostafavi Dental Enquiry Journal. 2020; 17(6): 439 [Pubmed] | [DOI]

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