Publication: Análisis in vitro de la influencia de la deformación y reparación de la rosca interna del implante en el mantenimiento de la precarga. Estudio piloto.
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2022
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Abstract
Introducción y objetivo principal:
La fractura del tornillo o componente atornillado de la restauración, es una complicación de las prótesis sobre implantes cuya resolución, puede implicar la pérdida del implante. Las técnicas disponibles actualmente se pueden clasificar como de riesgo bajo, moderado y alto de daño del implante. El perfilado o repasado de las roscas puede en muchos casos devolverle al implante dañado su funcionalidad, pero la bibliografía sobre su uso es muy limitada. El objetivo principal del estudio es la evaluación in vitro de la influencia de la deformación y posterior reconformación de la rosca interna de implantes de conexión externa, en el mantenimiento del torque tras la carga funcional.
Material y Método:
Se utilizaron 10 implantes de conexión externa hexagonal (Biomimetic Coral EC, Avinent® Implant System) con pilares para cementar angulados 17⁰, en el grupo Control. Se les aplicó el torque recomendado por el fabricante (35N) y se registraron los valores del torque de desinserción RT PRE (iChiropro, Bien Air). Las muestras se sometieron a la carga cíclica equivalente a un año de uso in vivo (300000 ciclos, a 200N y 2Hz) y se volvieron a registrar los valores de torque de desinserción (RTPOST). Las muestras se sometieron a un proceso de deformación de la rosca interna mediante la inserción a presión de una broca y se repararon las roscas con un macho para repasar roscas manual (Proclinic®). Se volvieron a atornillar los pilares, con tornillos nuevos, para formar el grupo de implantes reparados (REP). Se midieron los torques de desinserción antes y después de la carga funcional. Se realizó el análisis estadístico mediante los test t de Student para los valores iniciales, y con pruebas no paramétricas en el resto de variables.
Resultados:
Se observaron diferencias estadísticamente significativas entre los valores de torque inicial, siendo mayores los del grupo Control con una diferencia media de 6,75±1,86 (P=0.003). No hubo diferencias estadísticamente ignificativas entre los valores de torque finales de ambos grupos. Los porcentajes promedios de mantenimiento de la 3 precarga fueron 76,29% inicial y 53,31% final para el grupo Control y 57,14% inicial y 46,49% final para el grupo REP.
Conclusiones:
Teniendo en cuenta las limitaciones del presente estudio piloto, la deformación y reparación de las roscas internas de los implantes no afectó significativamente al mantenimiento del torque tras la carga funcional.
Introduction and main objective Fracture of the screw or screw-retained component of a restoration is a complication of implant-supported prostheses, and its reolution may result in the loss of the implant. Currently available techniques can be classified as low, moderate and high risk of implant damage. Thread cleaning or retapping can in many cases restore functionality to damaged implants, but the literature about its use is very limited. The main objective of this study is the in vitro evaluation of the influence of deformation and further retapping of the internal thread of external conection implants on the maintenance of preload after cyclic loading. Material and Methods Ten hexagonal external connection implants (Biomimetic Coral EC, Avinent® Implant System) with 17⁰ angled cementable abutments were used in the Control group. The recommended torque (35N) was applied and the RT PRE retrieval torque values (iChiropro, Bien Air) were recorded. The samples were submitted to cyclic load equivalent to one year of use in vivo (300000 cycles, at 200N and 2Hz) and the retrieval torque values were measured again (RT POST). The specimens were submitted to internal thread damaging by inserting a drill under pressure and the threads were retapped with a hand tapping tool (Proclinic®). The abutments were screwed back to the implants using new screws to establish the REP group. Retrieval torques were measured before and after functional loading. Statistical analysis was performed using Student's t-tests for initial values, and non-parametric tests for all other variables. Results Statistically significant differences were observed in the initial torque values between the two groups, with those of the Control group being greater with a mean difference of 6.75±1.86 (P=0.003). There were no statistically significant differences between the final torque values of the two groups. The mean percentages of preload maintenance were 76.29% initial and 53.31% final for the Control group and 57.14% initial and 46.49% final for the REP group. Conclusions Regarding the limitations of this pilot study, damaging and retapping of the internal implant threads did not significantly affect torque maintenance after functional loading.
Introduction and main objective Fracture of the screw or screw-retained component of a restoration is a complication of implant-supported prostheses, and its reolution may result in the loss of the implant. Currently available techniques can be classified as low, moderate and high risk of implant damage. Thread cleaning or retapping can in many cases restore functionality to damaged implants, but the literature about its use is very limited. The main objective of this study is the in vitro evaluation of the influence of deformation and further retapping of the internal thread of external conection implants on the maintenance of preload after cyclic loading. Material and Methods Ten hexagonal external connection implants (Biomimetic Coral EC, Avinent® Implant System) with 17⁰ angled cementable abutments were used in the Control group. The recommended torque (35N) was applied and the RT PRE retrieval torque values (iChiropro, Bien Air) were recorded. The samples were submitted to cyclic load equivalent to one year of use in vivo (300000 cycles, at 200N and 2Hz) and the retrieval torque values were measured again (RT POST). The specimens were submitted to internal thread damaging by inserting a drill under pressure and the threads were retapped with a hand tapping tool (Proclinic®). The abutments were screwed back to the implants using new screws to establish the REP group. Retrieval torques were measured before and after functional loading. Statistical analysis was performed using Student's t-tests for initial values, and non-parametric tests for all other variables. Results Statistically significant differences were observed in the initial torque values between the two groups, with those of the Control group being greater with a mean difference of 6.75±1.86 (P=0.003). There were no statistically significant differences between the final torque values of the two groups. The mean percentages of preload maintenance were 76.29% initial and 53.31% final for the Control group and 57.14% initial and 46.49% final for the REP group. Conclusions Regarding the limitations of this pilot study, damaging and retapping of the internal implant threads did not significantly affect torque maintenance after functional loading.
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