Subscribe to RSS

DOI: 10.1055/s-0045-1808257
Comparative Analysis of Screw Loosening between SynOcta and InOcta Tissue Level Abutments: An In Vitro Study

Abstract
Objective
Implants are one of the common treatments in dentistry. This treatment has various complications such as inflammation around the implant, failure of the coating, and screw loosening. Several factors contribute to screw loosening, including abutment type and collar height. Therefore, this study aims to compare the amount of loosening in two types of abutments—InOcta and SynOcta abutments.
Materials and Methods
In this laboratory study, 20 titanium fixtures of the Dentis brand were divided into two groups. Each group consisted of 10 fixtures. The fixtures were mounted vertically in acrylic blocks with dimensions of 20 × 6 × 10 mm. After installing the SynOcta and InOcta abutments, the screws were torqued to 30 N·cm and re-torqued after 10 minutes. Subsequently, the samples were transferred to a chewing simulator. A compressive force of 90 N was applied for 10,000 cycles at a frequency of 75 rpm. After loading, the torque required to loosen the screws was measured, and the loosening torque was calculated. The data were analyzed using an independent t-test, and a significance level (p-value) of less than 0.05 was considered.
Results
The mean de-torque for the tissue level InOcta abutments was calculated to be 25.75 N.cm, while the mean de-torque for the SynOcta abutments was 21.98 N.cm. A comparison using the t-test showed that the mean de-torque for the InOcta abutment group was significantly higher than the SynOcta group (p < 0.001).
Conclusion
The final results of the experiments indicate that under laboratory conditions, the de-torque of the abutment screw in the tissue level SynOcta group is significantly lower than that in the InOcta group (p < 0.001).
Publication History
Article published online:
07 May 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Jung RE, Pjetursson BE, Glauser R, Zembic A, Zwahlen M, Lang NP. A systematic review of the 5-year survival and complication rates of implant-supported single crowns. Clin Oral Implants Res 2008; 19 (02) 119-130
- 2 Srivastava S, Sarangi SK. A relationship of tightening torque and initial load of dental implant of nano bio-silica and bamboo fiber-reinforced bio-composite material. Comput Methods Biomech Biomed Engin 2024; (e-pub ahead of print)
- 3 Srivastava S, Sarangi SK. Study of torque characteristics and screw loosening in titanium alloy and fibre-reinforced composite dental implants. Compos Mech Comput Appl An Int J. 2024; 15 (01) 79-92
- 4 Srivastava S. A study on screw loosening in dental implant abutment. Crit Rev Biomed Eng 2025; 53 (01) 37-46
- 5 Srivastava S, Sarangi SK, Singh SP. An FEA analysis of nano-silica reinforced chitosan based dental implant under dynamic loading. Silicon 2024; 16: 6055-6072
- 6 Srivastava S, Kumar V, Yadav P, Singh B, Singh S, Sarangi S. Retightening of internal hexagonal and conical dental abutment connections: a FEA analysis. J Osseointegration 2024; 16 (01) 23-30
- 7 Sethi A, Kaus T, Sochor P. The use of angulated abutments in implant dentistry: five-year clinical results of an ongoing prospective study. Int J Oral Maxillofac Implants 2000; 15 (06) 801-810
- 8 Eger DE, Gunsolley JC, Feldman S. Comparison of angled and standard abutments and their effect on clinical outcomes: a preliminary report. Int J Oral Maxillofac Implants 2000; 15 (06) 819-823
- 9 The Glossary of Prosthodontic Terms: Ninth Edition. J Prosthet Dent 2017; 117 (5s): e1-e105
- 10 el Askary AS, Meffert RM, Griffin T. Why do dental implants fail? Part II. Implant Dent 1999; 8 (03) 265-277
- 11 Goodacre CJ, Kan JY, Rungcharassaeng K. Clinical complications of osseointegrated implants. J Prosthet Dent 1999; 81 (05) 537-552
- 12 Calderon PS, Dantas PM, Montenegro SC. et al. Technical complications with implant-supported dental prostheses. J Oral Sci 2014; 56 (02) 179-184
- 13 Jemt T, Laney WR, Harris D. et al. Osseointegrated implants for single tooth replacement: a 1-year report from a multicenter prospective study. Int J Oral Maxillofac Implants 1991; 6 (01) 29-36
- 14 Kreissl ME, Gerds T, Muche R, Heydecke G, Strub JR. Technical complications of implant-supported fixed partial dentures in partially edentulous cases after an average observation period of 5 years. Clin Oral Implants Res 2007; 18 (06) 720-726
- 15 Cho SC, Small PN, Elian N, Tarnow D. Screw loosening for standard and wide diameter implants in partially edentulous cases: 3- to 7-year longitudinal data. Implant Dent 2004; 13 (03) 245-250
- 16 McGlumphy EA, Mendel DA, Holloway JA. Implant screw mechanics. Dent Clin North Am 1998; 42 (01) 71-89
- 17 Winkler S, Ring K, Ring JD, Boberick KG. Implant screw mechanics and the settling effect: overview. J Oral Implantol 2003; 29 (05) 242-245
- 18 Zarb GA, Schmitt A. The longitudinal clinical effectiveness of osseointegrated dental implants: the Toronto study. Part III: problems and complications encountered. J Prosthet Dent 1990; 64 (02) 185-194
- 19 Carlson B, Carlsson GE. Prosthodontic complications in osseointegrated dental implant treatment. Int J Oral Maxillofac Implants 1994; 9 (01) 90-94
- 20 Lee KY, Shin KS, Jung JH, Cho HW, Kwon KH, Kim YL. Clinical study on screw loosening in dental implant prostheses: a 6-year retrospective study. J Korean Assoc Oral Maxillofac Surg 2020; 46 (02) 133-142
- 21 Siadat H, Pirmoazen S, Beyabanaki E, Alikhasi M. Does abutment collar length affect abutment screw loosening after cyclic loading?. J Oral Implantol 2015; 41 (Spec No): 346-351
- 22 Kitagawa T, Tanimoto Y, Odaki M, Nemoto K, Aida M. Influence of implant/abutment joint designs on abutment screw loosening in a dental implant system. J Biomed Mater Res B Appl Biomater 2005; 75 (02) 457-463
- 23 Jalalian E, Hashemi E, Naser Mostufi S. et al. Effect of abutment connection type and cyclic loading on removal torque value. Journal of Research in Dental and Maxillofacial Sciences. 2019; 4 (01) 36-40
- 24 Fathi A, Mosharraf R, Ghorbani M, Saberipour S. Effect of shape and design of the internal connection of tissue-level and bone-level implants on detorque values and removal forces: an in vitro study. J Prosthet Dent 2024; 131 (06) 1135.e1-1135.e5
- 25 Byrne D, Jacobs S, O'Connell B, Houston F, Claffey N. Preloads generated with repeated tightening in three types of screws used in dental implant assemblies. J Prosthodont 2006; 15 (03) 164-171
- 26 Ebadian B, Fathi A, Khodadad S. Comparison of the effect of four different abutment screw torques on screw loosening in single implant-supported prosthesis after the application of mechanical loading. Int J Dent 2021; 2021: 3595064
- 27 Dhingra A, Weiner S, Luke AC, Ricci JL. Analysis of dimensional changes in the screw and the surface topography at the interface of a titanium screw and a zirconia abutment under cyclic loading: an in vitro study. Int J Oral Maxillofac Implants 2013; 28 (03) 661-669
- 28 Bickford J, Oliver M. Introduction to the Design and Behavior of Bolted Joints: Non-Gasketed Joints 2022. 5th ed. CRC Press. doi: 10.1201/9780429243943
- 29 Al-Saloum ZJ. . Implant overdenture abutment loosening under hyperbaric conditions. 2024. Graduate Theses, Dissertations, and Problem Reports. 12325.
- 30 Freitas-Júnior AC, Almeida EO, Bonfante EA, Silva NR, Coelho PG. Reliability and failure modes of internal conical dental implant connections. Clin Oral Implants Res 2013; 24 (02) 197-202
- 31 Ahn S, Kim J, Jeong SC, Kim M, Kim C, Park D. Stress distribution analysis of threaded implants for digital dentistry. Int J Environ Res Public Health 2022; 19 (19) 12674
- 32 Cibirka RM, Nelson SK, Lang BR, Rueggeberg FA. Examination of the implant-abutment interface after fatigue testing. J Prosthet Dent 2001; 85 (03) 268-275
- 33 Kofron MD, Carstens M, Fu C, Wen HB. In vitro assessment of connection strength and stability of internal implant-abutment connections. Clin Biomech (Bristol) 2019; 65: 92-99
- 34 Sakamoto K, Homma S, Takanashi T. et al. Influence of eccentric cyclic loading on implant components: comparison between external joint system and internal joint system. Dent Mater J 2016; 35 (06) 929-937
- 35 Segundo RM, Oshima HM, da Silva IN, Burnett Jr LH, Mota EG, Silva LL. Stress distribution of an internal connection implant prostheses set: a 3D finite element analysis. Stomatologija 2009; 11 (02) 55-59
- 36 Junqueira MC, Silva TE, Ribeiro RF, Faria AC, Macedo AP, de Almeida RP. Abutment rotational freedom evaluation of external hexagon single-implant restorations after mechanical cycling. Clin Implant Dent Relat Res 2013; 15 (06) 927-933
- 37 Yenigun S, Ercal P, Ozden-Yenigun E, Katiboglu AB. Influence of abutment design on stress distribution in narrow implants with marginal bone loss: a finite element analysis. Int J Oral Maxillofac Implants 2021; 36 (04) 640-649
- 38 Bédouin Y, Lefrançois E, Salomon JP, Auroy P. Abutment rotational freedom on five implant systems with different internal connections. J Prosthet Dent 2023; 129 (03) 433-439
- 39 Zeno HA, Buitrago RL, Sternberger SS. et al. The effect of tissue entrapment on screw loosening at the implant/abutment interface of external- and internal-connection implants: an in vitro study. J Prosthodont 2016; 25 (03) 216-223
- 40 Sammour SR, Maamoun El-Sheikh M, Aly El-Gendy A. Effect of implant abutment connection designs, and implant diameters on screw loosening before and after cyclic loading: in-vitro study. Dent Mater 2019; 35 (11) e265-e271
- 41 Kim SK, Koak JY, Heo SJ, Taylor TD, Ryoo S, Lee SY. Screw loosening with interchangeable abutments in internally connected implants after cyclic loading. Int J Oral Maxillofac Implants 2012; 27 (01) 42-47
- 42 Pardal-Peláez B, Sanz-Alonso J, González-Serrano J, Montero-Martín J. Strategies to reduce torque loss of abutment screws. Journal of Oral Research and Review. 2018; 10 (02) 68-75