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Volume 27 , Issue 1
January/February 2014

Pages 7679

The Influence of Tightening Sequence and Method on Screw Preload in Implant Superstructures

Maha M. Al-Sahan, BDS, MSc/Nassr S. Al Maflehi, BS, MSc/Riyadh F. Akeel, BDS, MDSc, PhD

PMID: 24392482
DOI: 10.11607/ijp.3306

This study evaluated the effect of six screw-tightening sequences and two tightening methods on the screw preload in implant-supported superstructures. The preload was measured using strain gauges following the screw tightening of a metal framework connected to four implants. The experiment included six sequences ([1] 1-2-3-4, [2] 4-2-3-1, [3] 4-3-1-2, [4] 1-4-2-3, [5] 2-3-4-1, and [6] 3-2-4-1), two methods (onestep, three-step), and five replications. Significant differences were found between tightening sequences and methods. In the three-step method, a higher total preload was found in sequences 2 (312 85 N), 3 (246 54 N), and 4 (310 96 N). In the one-step method, a higher total preload was found in sequences 1 (286 94 N), 5 (764 142 N), and 6 (350 69 N). It is concluded that the highest total screw preload was achieved when anterior implants of the superstructure were first tightened in one step, followed by posterior implants. Int J Prosthodont 2014;27:7679. doi: 10.11607/ijp.3306

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