Screw removal torque evaluation in implants with cone morse and external hexagon platforms in anterior cantilever

Abstract

This study aims to evaluate the screw removal torque on prosthetic platforms of Cone Morse (CM) and External Hexagon (EH) implants in crowns with anterior cantilever. Materials and Methods: in vitro study with a sample consisting of 20 test specimens of 2 elements (21 and 22), with n = 40; load is simulated on element 21 or on cantilever of 22. Samples were divided into 4 groups consisting of 10 test specimens on CM implants (groups 1 and 2), and 10 test specimens on EH implants (groups 3 and 4).  The test specimens were manufactured using cylindrical PVC pipes measuring 22 x 19.05 mm filled with acrylic resin. The implants were fixed with a centralization device. Components used were EUCLAs and UCLAs with a  chrome-cobalt alloy molten base. The metal bases were scanned, the crowns were digitally waxed, made on CAD/CAM system, and cemented on the metal bases with Panavia cement. Torque was applied using 20N for CM and 32N for EH, according to the manufacturers’ instructions. The test specimens were then subjected to a cycling process consisting of 1,000,000 cycles at a frequency of 2 Hz. The cyclic process applied axial forces to the surface (palate face of 21 and 22). Two cycling processes were carried on, the first on the palate face of 21 and the second on the palate face of 22. Between the two, screws were removed and replaced by new ones. The screw removal torque was measured using a digital torque meter. Results were analyzed with Student’s t test and variance analysis. Statistical calculations were conducted in SPSS 23 using 5% of significance. Results: Student’s t test showed significantly lower removal torque values in comparison with initial torque for both CM and EH connection implants and force applied to elements 21 and 22 (p < 0.001) or 22 (p < 0.001). Considering torque loss, there was no significant effect of the interaction between type of implant connection and site of force application (p = 0.094). Removal torque was significantly lower than initial torque for both implants (CM and EH). Conclusion: Torque loss occurred both in CM and EH. There was no significant effect of the interaction between connections and site of force application.