Abutment rotational freedom on five implant systems with different internal connections.

STATEMENT OF PROBLEM: Information regarding the rotational freedom of internal connection implants is sparse. PURPOSE: The purpose of this in vitro study was to compare the rotational freedom of different internal conical and internal nonconical connections. MATERIAL AND METHODS: Thirty implants, 30 straight manufactured standard abutments, and 30 standard abutment screws were obtained for each of the 5 implant systems tested. Three implant systems had indexed internal conical connections with different antirotational geometries: hexagon (Naturall+), cam-groove (ID CAM M), and octagon (Bone Level). Two implant systems had internal nonconical connections with hexagonal antirotational geometry (Tapered Screw-Vent and Seven). The implants were mounted in a steel plate, and a metal reference arm was attached to the abutment. Before tightening the standard abutment screw, a modified torque wrench was used to rotate the abutment clockwise until reaching the clockwise rotational endpoint. This modified torque wrench was connected to the abutment's outer surface. It allowed free access to the standard abutment screw for a second torque wrench, specific to each implant system. The modified torque wrench applied a controlled torque of 5 Ncm, which held the abutment at the clockwise rotational endpoint. The standard abutment screw was then tightened to the manufacturer's specified torque value with the second torque wrench. Angle value corresponding to the clockwise endpoint was measured microscopically between a fixed reference point on the steel plate and the reference arm. The abutment was then unscrewed and removed. The same procedure was carried out to rotate the abutment counterclockwise and measure the angle value corresponding to the counterclockwise rotational endpoint. The rotational freedom was finally determined from the differences in the angles between the clockwise and counterclockwise rotational endpoints. Rotational freedom angle values were summarized as descriptive statistics (means, standard deviations). The normality test (Kolmogorov-Smirnov) was applied, and the Kruskal-Wallis test was performed. The Wilcoxon signed-rank test was used to isolate the implant system differences from each other (α=.05). RESULTS: The lowest mean rotational freedom angles were obtained for Bone Level (conical connection, 0.17 degrees) and Tapered Screw-Vent (nonconical connection, 0.05 degrees). These systems were followed in increasing order by ID CAM M (conical connection, 0.50 degrees), Seven (nonconical connection, 1.98 degrees), and Naturall+ (conical connection, 2.49 degrees). Compared with each other, all implant systems had significant statistical differences in rotational freedom angles (P<.05). CONCLUSIONS: Significant differences were found among the 5 implant systems. The lowest mean rotational freedom angles were obtained both with a conical connection (Bone Level) and a nonconical connection (Tapered Screw-Vent).

Enhancement of the biocompatibility by surface nitriding of a low-modulus titanium alloy for dental implant applications.

To enhance their longevity, dental implants must be highly biocompatible and must have a low elastic modulus close to that of the bone. They must also possess a high superficial hardness and a high corrosion resistance. For these reasons, a recently developed low-modulus Ti-27Nb alloy with nontoxic elements was treated by gas nitriding at high temperature in this study. A very thin nitrided layer of 0.5 µm in thickness followed by an enriched nitrogen zone was observed. Consequently, a very high hardness evaluated at about 1800 HV was obtained in surface, which represents an increase of 4-5 times the hardness of the non-nitrided alloy. This superficial hardness was experimentally observed to decrease up to 800 nm in depth from the surface to the core. The low modulus of Ti-27Nb (evaluated at 55 GPa, which is twice lower than the commercially pure titanium) was not affected by the surface nitriding treatment. A better corrosion resistance was observed and a significant decrease in ion release rates for the nitrided alloy (ion release of 1.41 ng/cm2 compared to the 163.58 ng/cm2 obtained for the commercially pure titanium at pH = 7.48 in artificial Carter-Brugirard saliva). The cytocompatibility was not compromised and the cell viability performed on human osteoblasts, fibroblastic cells, and epithelial cells was enhanced on the nitrided surface in comparison with the non-nitrided surface. These combined properties make the nitrided Ti-27Nb alloy a good candidate for dental implant applications. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1483-1490, 2019.

Torque resistance of impression copings after direct implant impression: An in vitro evaluation of impression materials with and without adhesive.

STATEMENT OF PROBLEM: No data are available on the ability of an impression coping to resist the manual placement of an abutment replica (implant analog) during prosthodontic laboratory procedures after a direct (pick-up) impression. PURPOSE: The purpose of this in vitro study was to evaluate the torque resistance of impression copings after a direct impression, that is, the amount of rotational torque sufficient to induce irreversible displacement of impression copings in the impression material bulk once the impression has been made. MATERIAL AND METHODS: A reference model with 5 abutment replicas was constructed. Five impression copings were screwed onto the abutment replicas, and standardized impressions were made. A controlled twisting force was applied to each impression coping. A torque tester recorded the torque variation. Three elastomeric impression materials were tested. ANOVA and the Tukey test (α=.05) were performed using an average of 30 measurements per impression material, with and without adhesive. RESULTS: ANOVA and the Tukey test results showed that the adhesive, cohesive, and mechanical bonds between the impression coping and the impression material depended greatly on the type of material and that the average rupture threshold of these bonds was statistically significantly different in pairwise comparisons (P<.05). The curve analysis showed that when the impression materials are used with adhesives, the deformation of the interface is irreversible beyond 5 Ncm of torque. CONCLUSIONS: The polyether impression material is the direct impression material that showed the highest breakdown threshold for adhesive bonding when used without an adhesive. The use of an adhesive on impression copings leads to irreversible deformation of the interface at torque stresses well below the adhesive bond threshold of the same materials used without an adhesive.