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      THE INFLUENCE OF SCREW TYPE, ALLOY AND CYLINDER POSITION ON THE MARGINAL FIT OF IMPLANT FRAMEWORKS BEFORE AND AFTER LASER WELDING Translated title: INFLUÊNCIA DO TIPO DE PARAFUSO, LIGA E DA POSIÇÃO DO CILINDRO NA ADAPTAÇÃO MARGINAL DAS INFRA-ESTRUTURAS SOB IMPLANTES ANTES E APÓS A SOLDAGEM A LASER

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          Abstract

          Misfit at the abutment-prosthetic cylinder interface can cause loss of preload, leading to loosening or fracture of gold and titanium screws. Objectives: To evaluate the influence of screw type, alloy, and cylinder position on marginal fit of implant frameworks before and after laser welding. Methods: After Estheticone-like abutments were screwed to the implants, thirty plastic prosthetic cylinders were mounted and waxed-up to fifteen cylindrical bars. Each specimen had three interconnected prosthetic components. Five specimens were one-piece cast in titanium and five in cobalt-chromium alloy. On each specimen, tests were conducted with hexagonal titanium and slotted gold screws separately, performing a total of thirty tested screws. Measurements at the interfaces were performed using an optical microscope with 5 μm accuracy. After sectioning, specimens were laser welded and new measurements were obtained. Data were submitted to a four-way ANOVA and Tukey's multiple comparisons test (α =0.05). Results: Slotted and hexagonal screws did not present significant differences regarding to the fit of cylinders cast in titanium, either in one-piece casting framework or after laser welding. When slotted and hexagonal screws were tested on the cobalt-chromium specimens, statistically significant differences were found for the one-piece casting condition, with the slotted screws presenting better fit (24.13μm) than the hexagonal screws (27.93 μm). Besides, no statistically significant differences were found after laser welding. Conclusions: 1) The use of different metal alloys do exert influence on the marginal fit, 2) The slotted and hexagonal screws play the exclusive role of fixing the prosthesis, and did not improve the fit of cylinders, and 3) cylinder position did not affect marginal fit values.

          Translated abstract

          A desadaptação na interface abutment-cilindro protético pode causar perda da pré-carga, levando ao afrouxamento ou fratura dos parafusos de ouro e titânio. Objetivos: Avaliar a influência do tipo de parafuso, liga e posição do cilindro na adaptação marginal de infra-estruturas sobre implante antes e após a soldagem a laser. Métodos: Após os abutments do tipo Estheticone serem aparafusados nos implantes, trinta cilindros protéticos de plástico foram montados e encerados com 15 barras cilíndricas. Cada espécime possuía três componentes protéticos interconectados. Cinco espécimes foram fundidos em monobloco com liga de titânio e liga de cobalto-crômio. Em cada espécime, os testes foram conduzidos com parafusos hexagonais de titânio e com parafusos de ouro com fenda, separadamente, num total de 30 parafusos testados. As medidas nas interfaces foram feitas com microscópio óptico com 5μm de precisão. Após o seccionamento, os espécimes foram soldados a laser e novas medidas obtidas. Os dados foram submetidos para análise com os testes ANOVA a quatro critérios e Tukey para comparações múltiplas (α =0,05). Resultados: Os parafusos com fenda e hexágono não apresentaram diferenças significantes independente da adaptação dos cilindros fundidos em titânio, tanto em monobloco como após a soldagem a laser. Quando os parafusos com hexágono e fenda foram testados nos espécimes de cobalto-crômio, diferenças estatisticamente significantes foram encontradas na condição monobloco, com os parafusos fendidos apresentando melhor adaptação (24,13μm) do que os com hexágono (27,93 μm). Além disso, nenhuma diferença significante foi encontrada após a soldagem a laser. Conclusões: 1) O uso de diferentes ligas metálicas exerce influência nos resultados, 2) Os parafusos com hexágono e fenda somente possuem o papel de fixar a prótese, e não melhoram a adaptação dos cilindros e 3) a posição do cilindro não afetou os valores de adaptação marginal.

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          Most cited references53

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          Clinical methods for evaluating implant framework fit.

          Passive fit of implant-supported-prosthesis frameworks has been suggested as a prerequisite for successful long-term osseointegration. However, there are no scientific guidelines as to what is passive fit and how to achieve and measure it. The purpose of this article is to discuss passive fit and to review the various clinical methods that have been suggested for evaluating implant framework fit.Methods. The dental literature was reviewed to identify the clinical methods that have been used to evaluate implant framework fit. The suggested levels of passive fit are empirical. Numerous techniques have been advocated to evaluate the prosthesis-implant interface, but none individually provides objective results. It is suggested that clinicians use a combination of the available methods to minimize misfits.
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            Passivity of fit and marginal opening in screw- or cement-retained implant fixed partial denture designs.

            The relationship of stress generation upon placement of cement-retained or screw-retained implant restorations has not been thoroughly investigated. Passivity of fit and marginal discrepancies of screw- and cement-retained implant fixed partial denture (FPD) designs were determined using a photoelastic model of a partially edentulous posterior mandibular arch with 3 screw-type implants. Buccal and lingual marginal openings, measured with a traveling microscope before cementation or screw tightening, revealed no statistical difference in adaptation between designs. Screw tightening caused a reduction in marginal opening (changes significant, P < .05). The opening with the cemented FPDs was similar before and after cementation. Photoelastic evaluation of the FPDs showed that cement-retained FPDs exhibited a more equitable stress distribution than did their screw-retained counterparts.
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              Loose gold screws frequently occur in full-arch fixed prostheses supported by osseointegrated implants after 5 years.

              The possible occurrence of loose gold and abutment screws retaining full-arch osseointegrated prostheses has been investigated. The prostheses had been in use for at least 5 years. The findings were related to clinical parameters such as accuracy of the superstructure, operator dependence, and clinical and radiological diagnosis of implant status after 5 years. The principles of the California Dental Association's (CDA) quality evaluation criteria were modified and applied in the study. Gold screw loosening was found to be related to framework misfit and was considered to be operator dependent to some extent. It is recommended that full-arch fixed prostheses be retightened after 5 years.
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                Author and article information

                Journal
                J Appl Oral Sci
                J Appl Oral Sci
                Journal of Applied Oral Science
                Faculdade de Odontologia de Bauru da Universidade de São Paulo (Bauru )
                1678-7757
                1678-7765
                April 2006
                April 2006
                : 14
                : 2
                : 77-81
                Affiliations
                [1 ]DDS, MSc, Graduate Student, Department of Dental Materials, Bauru Dental School, University of São Paulo, Brazil
                [2 ]DDS, Graduate Student, Department of Prosthodontics, Bauru Dental School, University of São Paulo, Brazil
                [3 ]DDS, MSc, Graduate student, Department of Prosthodontics, Bauru Dental School, University of São Paulo, Brazil
                [4 ]DDS, MSc, PhD, Associate Professor, Department of Prosthodontics, Bauru Dental School, University of São Paulo, Brazil
                Author notes
                Corresponding address:Wellington Cardoso Bonachela – Departamento de Prótese – Al. Dr. Octávio Pinheiro Brisola, 9-75 Cep.: 17012-101 Bauru – SP – e-mail: wbonach@ 123456fob.usp.br
                Article
                S1678-77572006000200003
                10.1590/S1678-77572006000200003
                4327446
                19089035
                c923015e-2c7a-48b6-813f-57a96c181267

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 06 December 2004
                : 18 May 2005
                : 19 January 2006
                Page count
                Figures: 4, Tables: 1, Equations: 0, References: 31, Pages: 5
                Categories
                Original Article

                gold screw,titanium screw,laser welding,osseointegrated implants

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