Implant-abutment screw joint preload of 7 hex-top abutment systems

This study measured the screw joint preload of the implant-abutment interface for 7 common hex-top abutment systems. Increasingly, prosthetic designs are utilizing a direct prosthetic connection to the implant, placing the implant-abutment screw joint under direct functional loads and moments. Sufficiently high screw joint preloads are required to maintain screw joint integrity and confer clinical longevity to implant prosthetic components to prevent such complications as abutment screw loosening and screw fracture. Strain-gauged abutment load cells were calibrated to measure screw joint pre-load at the implant-abutment interface. Torque delivery by electronic torque controller was varied at low- and high-speed settings. At manufacturer's recommended torques, the overall mean preload measured was 181.6 +/- 60.0 N for the Nobel Biocare Standard abutment, 291.3 +/- 41.2 N for the Nobel Biocare EsthetiCone abutment, 456.5 +/- 44.0 N for the Nobel Biocare MirusCone abutment, 369.7 +/- 32.9 N for the 3i Titanium Abutment post, 643.4 +/- 143.1 N for the Nobel Biocare CeraOne abutment, 536.3 +/- 68.6 N for the Nobel Biocare "Gold Cylinder to Fixture" abutment, and 556.9 +/- 145.6 N for the Nobel Biocare TiAdapt abutment. Analysis of variance revealed significant differences between abutment systems (P < .001) and between torque driver speed settings (P < .001). Implant-abutment screw joint preload of external-hex implants is dependent on abutment design, screw diameter, material, tightening torque, and torque controller speed.