Experimental comparison of screw loosening of full zirconia crowns supported by straight implants, straight implants with angled abutments, and angled implants with different platform inclinations: An in vitro study

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Abstract

BACKGROUND: The success of placing an immediate implant in the area of the maxillary central incisor depends on the degree of tightening of the fixation screw for full zirconia crown. Clinicians use implants of various designs and angled abutments to bypass anatomical limitations, achieve a stable primary implant, and fabricate a screw-retained crown. However, a crown fabricated for an implant can experience non-axial loads during occlusion, which can loosen screws and adversely affect treatment success, particularly during the early postoperative period.

AIM: To compare the effect of cyclic loading on the reliability of the fixation screw for a full zirconia crown supported by an angled implant with platform inclinations of 12, 24, and 36 using straight implants or straight implants with an angled abutments.

MATERIALS AND METHODS: The degree of prosthetic screw tightening was studied in 30 samples (six groups of 5 implant types, such as straight implants, straight implants with standard 17° angled abutments, or 12° custom abutments and angled implants with platform inclinations of 12°, 24°, and 36°). A full zirconia crown was fabricated for the maxillary central incisor, fixed on every implant, and exposed to cyclic loading for 1×106 cycles. Then, the maximum unscrewing torque was determined for each group, and statistical analysis was carried out.

RESULTS: The minimum values of the maximum torque value was 20.804±0.01 N/cm for the group of straight implants with 17° angled abutments and the maximum value for the group of straight implants was 22.82±0.04 N/cm. However, the values in these groups were higher than those of the groups of implants with angled abutments.

CONCLUSION: This study showed that fixation screws are more reliable in crowns supported by straight implants or angled implants with different platform inclinations. Therefore, these implants are the preferred option for placing an implant in the anterior region.

About the authors

Khava M. Merzhoeva

People’s Friendship University of Russia

Email: kh_a_va@mail.ru
ORCID iD: 0000-0002-4049-6229
SPIN-code: 3549-7597

Postgraduate Student

Russian Federation, Moscow

Mikhail A. Murashov

Moscow State University of Medicine and Dentistry

Author for correspondence.
Email: mmurashov@yahoo.com
ORCID iD: 0000-0002-3309-538X
SPIN-code: 3355-6397

MD, Cand. Sci. (Med.), Assistant Professor

Russian Federation, Moscow

Igor A. Voronov

People’s Friendship University of Russia

Email: voronov77@mail.ru
ORCID iD: 0000-0002-6873-5869
SPIN-code: 8186-2654

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Moscow

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10. Fig. 1. Implant was fixed to steel cylinder filled in acrylic resin.

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11. Fig. 2. Crowns fixed to implants (lateral view).

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12. Fig. 3. Crowns fixed to implants (frontal view).

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13. Fig. 4. Crowns fixed to custom made angulated abutment.

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14. Fig. 5. Torque sensor.

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15. Fig. 6. Test dynamic machine.

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16. Fig. 7. Titanium bar with hemisphere.

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