Misfit simulation on implant prostheses with different combinations of engaging and nonengaging titanium bases. Part 2: Screw resistance test

Abstract

Statement of problemProsthesis fit is 1 of the main factors influencing the success and survival of an implant-supported screw-retained restoration. However, scientific validation of the performance of engaging and nonengaging components in a fixed partial denture (FPD) and the effect of their combinations on the fit of FPDs is lacking. The screw resistance test has been used for the fit assessment of screw-retained FPDs. However, objective assessments by using analog and digital devices are now available. PurposeThe purpose of this in vitro study was to investigate the effect of engaging and nonengaging components on the fit of screw-retained frameworks, supported by 2 conical connection implants with simulated vertical and horizontal misfits, by performing 2 different screw resistance tests (analog and digital). Material and methodsThirty 2-implant-supported bar-shaped zirconia frameworks cemented on two 2-mm titanium bases were fabricated and divided into 3 groups (n=10) according to different abutment combinations: both engaging, engaging and nonengaging, both nonengaging. The fit of each framework was tested on the control cast and on 6 definitive casts simulating 50-, 100-, and 150-μm vertical and 35-, 70-, and 100-μm horizontal misfit levels. The abutment screws were tightened on each implant, and the screw rotation angle was measured both digitally, with a custom-made digital torque wrench and a computer software program, and conventionally, with an analog torque wrench and protractor. Clearly ill-fitting specimens were excluded. The data were statistically analyzed by 1-way analysis of variance (ANOVA) and the Tukey post hoc test (α=.05). ResultsBoth engaging specimens on the 100-μm horizontal misfit group and on all vertical misfit groups were clearly ill-fitting and excluded. Statistically significant differences among groups with different combinations of abutments were found (P<.05). The engaging abutments had a higher angle of rotation than the nonengaging abutments on all casts. In the horizontal misfit group, both engaging specimens had the highest angle of rotation, followed by engaging and nonengaging and both engaging specimens. In the vertical misfit group, the engaging and nonengaging specimens had the highest angle of rotation on the side of the engaging abutment. The angle of rotation increased with the increasing level of misfit. ConclusionsBoth nonengaging frameworks showed superiority in misfit tolerance, as the angle of rotation was lower than that of the engaging and nonengaging and both engaging frameworks. Conventional and digital torque wrenches showed similar results.