The effect of contaminating media on the static and dynamic mechanical resilience of dental implant abutments' screws: In vitro study

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research Pub Date : 2023-09-07 DOI:10.1111/cid.13271

Keren Shemtov-Yona, Adi Arieli, Mohana Barhum, Raphael Pilo, Shifra Levartovsky

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Abstract

Introduction

This in vitro study aims to biomechanically evaluate the influence of medium contamination for example, saliva, blood, chlorhexidine (liquid and gel), and fluoride mouthwash on the biomechanical behavior of implant abutments' screws under static and dynamic loading.

Methods

Forty five Ti6Al4V commercial dental implants and abutments were tested in this study. Two main mechanical tests were carried out in the selected media. The first, static, aimed to evaluate the torque loss after the first tightening. The second, dynamic, involved a random cyclic load range between 0 and 200 N to evaluate torque loss due to mastication. In addition, metallographic longitudinal and cross-sections of the abutment-implant apparatus were examined to evaluate the abutment screw–abutment-implant interface.

Results

The static torque test showed that irrespective of the media, no statistical difference in static torque loss was found prior to dynamic loading. For the dynamic tests, torque-angle evolution analysis during tightening to 30 Ncm and after the spectrum loading, showed the same global mechanical behavior for all media, but the statistical analysis indicated a difference between the groups in reverse torque values (RTV) and in the torque loss due to dynamic loading. The medium groups CHX, CHX-gel, and Fluoride mouthwash, showed a meaningful torque loss due to loading, but the medium groups, control (no medium), blood and saliva showed an opposite trend and required a higher torque to open the abutment screws. The microstructural analysis revealed clear signs of cold-welding/galling, post-dynamic loading in these latter groups.

Conclusions

The presence of lubrication/contamination media (CHX mouthwash/CHX-gel/Fluoride mouthwash) reduces the preload generated due to tightening but prevents damage due to galling. The observed reduction of RTV clearly emphasizes the need for frequent abutment screw retightening for implant-supported prosthetic long-term stability.

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污染介质对种植牙基台螺钉静态和动态机械回弹性的影响：体外研究

引言本体外研究旨在从生物力学角度评估唾液、血液、洗必泰（液体和凝胶）和含氟漱口水等介质污染对种植基台螺钉在静态和动态负荷下的生物力学行为的影响。方法本研究测试了 45 个 Ti6Al4V 商用牙科种植体和基台。在选定的介质中主要进行了两项机械测试。第一项是静态测试，目的是评估首次拧紧后的扭矩损失。第二项是动态测试，在 0 到 200 N 之间随机循环加载，以评估咀嚼造成的扭矩损失。此外，还对基台-种植体装置的金相纵切面和横切面进行了检查，以评估基台螺钉-基台-种植体界面。结果静态扭矩测试表明，无论使用何种介质，动态加载前的静态扭矩损失均无统计学差异。对于动态测试，在拧紧至 30 Ncm 和频谱加载后的扭矩-角度演变分析表明，所有介质的总体机械性能相同，但统计分析显示，各组之间在反向扭矩值 (RTV) 和动态加载导致的扭矩损失方面存在差异。CHX、CHX-凝胶和含氟漱口水介质组显示出有意义的加载扭矩损失，但对照组（无介质）、血液和唾液介质组显示出相反的趋势，需要更大的扭矩才能打开基台螺丝。微观结构分析表明，在后几组中，有明显的冷焊/剥落迹象，即动态加载后的迹象。结论润滑/污染介质（CHX 漱口水/CHX-凝胶/氟化物漱口水）的存在降低了拧紧时产生的预紧力，但防止了咬合造成的损坏。观察到的 RTV 的减少明确强调了经常重新拧紧基台螺丝以实现种植体支持修复体的长期稳定性的必要性。

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来源期刊

Clinical Implant Dentistry and Related Research 医学-牙科与口腔外科

CiteScore

6.00

自引率

13.90%

发文量

103

审稿时长

4-8 weeks

期刊介绍： The goal of Clinical Implant Dentistry and Related Research is to advance the scientific and technical aspects relating to dental implants and related scientific subjects. Dissemination of new and evolving information related to dental implants and the related science is the primary goal of our journal. The range of topics covered by the journals will include but be not limited to: New scientific developments relating to bone Implant surfaces and their relationship to the surrounding tissues Computer aided implant designs Computer aided prosthetic designs Immediate implant loading Immediate implant placement Materials relating to bone induction and conduction New surgical methods relating to implant placement New materials and methods relating to implant restorations Methods for determining implant stability A primary focus of the journal is publication of evidenced based articles evaluating to new dental implants, techniques and multicenter studies evaluating these treatments. In addition basic science research relating to wound healing and osseointegration will be an important focus for the journal.