Torque generated by handheld screwdrivers and mechanical torquing devices for osseointegrated implants

This study evaluated the ability of practitioners experienced in the use of Brãnemark implant components to impart a desired torque using handheld screwdrivers. The torque output and variability of mechanical torque devices was also examined. For clinicians using handheld screwdrivers, values ranged from 0.7 to 18.1 Ncm, 1.4 to 33.7 Ncm, and 8.2 to 36.2 Ncm for the 10-Ncm, 20-Ncm, and 32-Ncm torques respectively. The manually operated mechanical torquing devices produced torque values within the tolerances specified by their respective manufacturers at all levels. Significant variation from the manufacturer's set values were noted as a function of tightening speed with the electronic torquing device. The data indicate that there is wide variation in the ability of clinicians to perceive adequate torquing forces applied to implant components. Calibrated torquing devices are mandatory if proper torquing procedures are to be accomplished.