Wave analysis of implant screw loosening using an air cylindrical cyclic loading device

The mechanics of implant screw loosening or fracture are well understood in the field of engineering. They have not been as widely explored in dentistry.

This study investigated the effects of simulated mastication on implant components and used wave analysis to document the basic mechanisms of screw loosening in a simulated oral environment.

A pneumatic cylindrical cyclic loading device was fabricated to simulate masticatory movement. Thirteen standard abutments were connected on external hexagonal implants with titanium abutment screws tightened to 20 Newton centimeters (Ncm), and single crowns were retained with gold screws tightened to 10 Ncm on each abutment, respectively. Ten single-implant crowns were loaded with the use of a cyclic loading device with 100 N of force at 30 degrees angles to the long-axis for 0.2 seconds of contact time with a frequency of 1 Hz. Three crowns were loaded vertically under the same conditions to serve as the control group. The effects of up to 1 million cyclic loads and various tightening torque forces (2, 4, 6, 8, 10, and 12 Ncm) on screw loosening were evaluated by wave analysis. A software program was written to record every wave mode and to stop the machine automatically if the amount of horizontal displacement of the crown was more than 0.5 mm, which was designated to represent perceptible loosened implant crown mobility clinically. The general wave patterns and characteristics of loosened and stable screws and the effect of various tightening torques were analyzed by comparing the differences in wave patterns.

The wave mode was divided into 4 stages for loosened gold screws: initial displacement, initial vibration, elastic deformation, and recovery stage. However, the initial displacement and initial vibration stages were not discernible for stable gold screws. Of the 10 gold occlusal screws, 4 loosened before the 1 million cyclic loads in the 10 single crowns tested. There was no screw loosening in the control group. There was no effect of screw loosening on the elastic deformation stage.

Within the limitations of this study, tightening torque had a significant effect on screw loosening. It would appear that more than 10 Ncm of tightening torque should be recommended for the gold screws in this external hexagon implant system.