SavedAdd your journal

Journals / ADO Klinik Bilimler Dergisi / 2026 / Cilt: 15 Sayı: 2

Effect of Preload on Different Implant Abutments in Terms of Screw Loosening

Ön Yüklemenin Farklı İmplant Abutmentlerindeki Vida Gevşemesine Etkisi

Mehmet Ali Kılıçarslan(ANKARA ÜNİVERSİTESİ, DİŞ HEKİMLİĞİ FAKÜLTESİ)0000-0002-8619-957X
Bora Akat(ANKARA UNIVERSITY)0000-0003-2928-2526
Yezdan Dilan Erkcan0000-0002-0582-8208
Burak Bilecenoğlu(ANKARA MEDİPOL ÜNİVERSİTESİ)0000-0001-7097-1572
Kaan Orhan(ANKARA UNIVERSITY, FACULTY OF DENTISTRY, DENTISTRY PR.)0000-0001-6768-0176
Pages
77–85
Publication Date
2026-05-20
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Therefore, tightening the implants repeatedly using a torque wrench after preloading (retightening) plays a significant role in clinically preventing screw loosening and consequently major clinical problems such as screw fractures.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aim: This study aimed to compare the mechanical behavior of the implant-abutment connection in cases where appropriate preloading is performed or not.
📊
Key Findings & Data:Materials and Methods: A total of 54 bone-level implants with a diameter of 3.5 mm were employed in this study.
💡
Conclusion & Impact:Therefore, tightening the implants repeatedly using a torque wrench after preloading (retightening) plays a significant role in clinically preventing screw loosening and consequently major clinical problems such as screw fractures.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:Dental implant · Ön Yükleme · Vida Gevşemesi

Abstract

Aim: This study aimed to compare the mechanical behavior of the implant-abutment connection in cases where appropriate preloading is performed or not. Materials and Methods: A total of 54 bone-level implants with a diameter of 3.5 mm were employed in this study. Each group was further divided into subgroups, each of which was tightened manually and with a torque wrench, and a total of six groups were tested, three of them being control groups. Manual tightening was performed by the same researcher with maximum manual force and tightening with a torque wrench was performed with a value of 30 Ncm by the same researcher. Sample measurement values in which connection compliance is evaluated using micro-CT. Results: The total space volume between the screw and the implant body (single torque minimum 0.32 mm³) decreased significantly in the samples tightened for the second time (minimum 0.20 mm³). Still, no difference was observed between tightening manually or with a torque wrench a second time, except for the angled abutment group. Conclusion: Tightening a second time after preload significantly reduced the gap values, especially when using a torque wrench. Therefore, tightening the implants repeatedly using a torque wrench after preloading (retightening) plays a significant role in clinically preventing screw loosening and consequently major clinical problems such as screw fractures.

Özet

Amaç: Bu çalışmanın amacı; uygun ön yüklemenin yapıldığı veya yapılmadığı durumlarda implant-abutment bağlantısının mekanik davranışını karşılaştırmaktır. Gereç ve Yöntemler: Bu çalışmada çapı 3.5 mm olan toplam 54 adet kemik seviyesi implant kullanılmıştır. Her grup, her biri manuel ve tork anahtarıyla sıkılan alt gruplara ayrılmış ve ilk üçü kontrol grubu olmak üzere toplam 6 grup test edilmiştir. Manuel sıkma aynı araştırmacı tarafından maksimum kişisel kuvvetle, el tornavidası ile sıkma ise aynı araştırmacı tarafından 30 Ncm değerinde gerçekleştirilmiştir. Bağlantı uyumunun mikro-BT kullanılarak değerlendirildiği örnek ölçüm değerleri elde edilmiştir. Bulgular: Vida ile implant gövdesi arasındaki toplam boşluk hacmi, tek sıkılan örneklere göre (minimum 0.32 mm³) ikinci kez sıkılan örneklerde önemli ölçüde azalmıştır (minimum 0.20 mm³). Bununla birlikte açılı abutment grubu dışında, manuel veya tork anahtarıyla ikinci kez sıkma arasında bir fark gözlenmemiştir. Sonuç: Ön yüklemeden sonra ikinci kez sıkma, özellikle tork anahtarı kullanıldığında boşluk değerlerini önemli ölçüde azalttı. Bu nedenle, ön yüklemeden sonra implantları tork anahtarı kullanarak ve tekrarlayarak sıkmak klinik olarak hasta ağızında vida gevşemesini dolayısıyla vida kırıkları gibi büyük klinik problemleri önlemede önemli bir rol oynar.

🔖

Cite This Article

Kılıçarslan, M. A., Akat, B., Erkcan, Y. D., Bilecenoğlu, B., Orhan, K. (2026). Effect of Preload on Different Implant Abutments in Terms of Screw Loosening. ADO Klinik Bilimler Dergisi, Cilt: 15 Sayı: 2, 77–85. https://doi.org/10.54617/adoklinikbilimler.1722215

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (37)

  1. Karunagaran S, Markose S, Paprocki G, Wicks R. A systematic approach to definitive planning and designing single and multiple unit implant abutments. J. Prosthodont 2014;23:639-48.
  2. Ramalho I, Witek L, Coelho PG, Bergamo E, Pegoraro LF, Bonfante EA. Influence of abutment fabrication method on 3D fit at the implant-abutment connection. Int J Prosthodont 2020;33:641-7.
  3. Huang Y, Wang J. Mechanism of and factors associated with the loosening of the implant abutment screw: A review. J Esthet Restor Dent 2019;31:338-45.
  4. Cibirka RM, Nelson SK, Lang BR, Rueggeberg FA. Examination of the implant-abutment interface after fatigue testing. J Prosthet Dent 2001;85:268-75.
  5. Michalakis KX, Calvani PL, Muftu S, Pissiotis A, Hirayama H. The effect of different implant-abutment connections on screw joint stability. J Oral Implantol 2014;40:146-52.
  6. Sakamoto K, Homma S, Takanashi T, Takemoto S, Furuya Y, Masao Y, Yajima Y. Influence of eccentric cyclic loading on implant components: comparison between external joint system and internal joint system. Dent Mater J 2016;35:929-37.
  7. Pjetturson BE, Zarauz C, Strasding M, Sailer I, Zwahlen M, Zembic A. A systematic review of the influence of the implant-abutment connection on the clinical outcomes of ceramic and metal implant abutments supporting fixed implant reconstructions. Clin Oral Implants Res 2018;29:160–83.
  8. Sailer I, Sailer T, Stawarczyk B, Jung R, Hammerle H. In vitro study of the influence of the type of connection on the fracture load of zirconia abutments with internal and external implant-abutment connections. Int J Oral Maxillofac Implants 2009;24:850-8.
  9. Truninger TC, Stawarczyk B, Leutert CR, Sailer TR, Hammerle CHF, Sailer I. Bending moments of zirconia and titanium abutments with internal and external implant-abutment connections after aging and chewing simulation. Clin Oral Implants Res 2012;23:12-8.
  10. Gracis S, Michalakis K, Vigolo P, Von Steyern PY, Zwahlen M, Sailer I. Internal vs. external connections for abutments/reconstructions: a systematic review. Clin Oral Implants Res 2016;23:202-16.
  11. Coppedê AR, De Mattos MG, Rodrigues RC, Ribeiro RF. Effect of repeated torque/mechanical loading cycles on two different abutment types with internal tapered connections: An in vitro study. Clin Oral Implants Res 2009;20:624-32.
  12. Shafie HR, Martyna S. Clinical and Laboratory Manual of Dental Implant Abutments. 1st ed. Hoboken NJ: Wiley-Blackwell;2014; p.23-24.
  13. Bozkaya D, Muftu S, Muftu A. Evaluation of load transfer characteristics of five different implants in compact bone at different load levels by finite elements analysis. J Prosthet Dent 2004;92:523-30.
  14. Chun HJ, Shin HS, Han CH, Lee SH. Influence of implant abutment type on stress distribution in bone under various loading conditions using finite element analysis. Int J Oral Maxillofac Implants 2006;21:195-202.
  15. Maeda Y, Satoh T, Sogo M. In vitro differences of stress concentrations for internal and external hex implant-abutment connections: a short communication. J Oral Rehabil 2006;33:75-8.
  16. Sarfaraz H, Paulose A, Shenoy KK, Hussain A. A three-dimensional finite element analysis of a passive and friction fit implant abutment interface and the influence of occlusal table dimesion on the stress distribution pattern on the implant and surrounding bone. J Indian Prosthodont Soc 2015;15:3.
  17. Karl M, Taylor TD. Parameters determining micromotion at the implant-abutment interface. Int J Oral Maxillofac Implants 2014;29:1338-47.
  18. Norton MR. Assessment of cold welding properties of the internal conical interface of two commercially available implant systems. J Prosthet Dent 1999;81:159-66.
  19. Cho SC, Small PN, Elian N, Tarnow D. Screw loosening for standard and wide diameter implants in partially edentulous cases: 3- to 7- year longitudinal data. Implant Dent 2004;13:245-50.
  20. Moris ICM, Faria ACL, Ribeiro RF, Rodrigues RCS. Torque loss of different abutment size before and after cyclic loading. Int J Oral Maxillofac Implants 2015;30:1256-61.
  21. Hirayama PMA, Bohner LOL, Marotti J, Steagall W, Lagana DC, Tortamano P. Influence of Abutment Surface Treatments on Screw Loosening of Morse Taper Implants. Implant Dent 2017;26:718-22.
  22. DE Kok IJ, Duqum Is, Katz LH, Cooper LF. Management of implant/prosthodontic complications. Dent Clin North Am 2018;2:217-31.
  23. Nithyapriya S, 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.
  24. Pardal-Peláez B., Montero J. Preload loss of abutment screws after dynamic fatigue in single implant-supported restorations. A systematic review. J Clin Exp Dent 2017;9:1355-61.
  25. Gupta S, Gupta H, Tandan A. Technical complications of implant- causes and management: A comprehensive review. Natl J Maxillofac Surg 2015; 6:3-8.
  26. Bulaqi HA, Barzegar A, Paknejad M, Safari H. Assessment of preload, remaining torque, and removal torque in abutment screws under different frictional conditions: A finite element analysis. J Prosthet Dent 2019;121:e1-7.
  27. Satpathy M, Jose RM, Duan Y, Girrigs JA. Effect of abutment screw preload and preload simulation techniques on dental implant lifetime. JADA found Sci 2022;1:1-18.
  28. Gratton DG, Aquilino SA, Stanford CM. Micromotion and dynamic fatigue properties of the dental implant-abutment interface. J Prosthet Dent 2001;85:47-52.
  29. Kourtis S, Damanaki M, Kaitatzidou S, Kaitatzidou A, Roussou V. J esthet Restor Dent 2017;29:233-46.
  30. Alsheghri AA, Abdalla AN, Mokahhal B, Cortes ARG, Garcia-Denche JT, Celemin A, et al. Development of a peak insertion torque prediction model for parallel-walled dental implants. Med Eng Phys 2025;138:1-10.
  31. Lang LA, Kang B, Wang RF, Lang BR. Finite element analysis to determine implant preload. J Prosthet Dent 2003;90:539-46.
  32. Shetty M, Krishna Prasad D, Shetty NH, Jaiman R. Implant abutment connection: Biomechanical Perspectives. NUJHS 2014;4:47-53.
  33. El-Sheikh MAY, Mostafa TMN, El-Sheikh MM. Effect of different angulations and collar lengths of conical hybrid implant abutment on screw loosening after dynamic cyclic loading. Int J Implant Dent 2018;4:1-12.
  34. Parnia F, Yazdani J, Fakour P, Mahboub F, Pakdel SMV. Comparison of the maximum hand-generated torque by professors and postgraduate dental students for tightening the abutment screws of dental implants. J Dent Res Dent Clin Dent Prospects 2018;12:190-5.
  35. Seloto CB, Strazzi-Sahyon, HB, dos Santos, PH, Assunção VG. Effectiveness of Sealing Gel on Vertical Misfit at the Implant-Abutment Interface and Preload Maintenance of Screw-Retained Implant-Supported Prostheses. Int J Oral Maxillofac Implants 2020;35:479-84.
  36. Binon PP. Implants and components: Entering the new millennium. Int J Oral Maxillofac Implants 2000;15: 76-94.
  37. Meng JC, Everts JE, Qian F, Gratton DG. Influence of connection geometry on dynamic micromotion at the implant-abutment interface. Int J Prosthodont 2007;20: 623-5.