Displacement of Implant Abutments Following Initial and Repeated Torqueing

Purpose: To measure and compare the three-dimensional (3D) position of nine different abutments manufactured by different manufacturers after repeated torqueing on an internal-hexagon implant. Materials and Methods: Nine tapered implants were placed into an acrylic resin block. Five specimens each of nine different abutments (n = 45) were placed into one of nine implants. The abutments were handtightened and then torqued to the manufacturer-recommended torque of 30 Ncm. After 10 minutes, 30 Ncm of torque was reapplied. Another 10 minutes elapsed before testing was completed. Images were recorded in 12-second intervals. The spatial relationship of the abutments to the resin block was determined using 3D digital image correlation. Commercial image correlation software was used to analyze the displacements. Mean displacements for the abutments were calculated in three dimensions and overall for both torque applications. Statistical comparisons were done with a t test and a step-down Bonferroni correction. Results: The overall 3D displacement of the Atlantis Titanium abutment after the second applied torque was significantly greater than that of two of the eight other abutments. Displacement in all three dimensions for the Atlantis Titanium abutment changed direction between the first and second torque applications. All abutments moved further in the same direction except for the Atlantis Titanium abutment, which moved back toward its original hand-tightened position horizontally after the second torque application. Conclusion: Re-torqueing of abutments after a 10-minute interval leads to minor displacement of varying degrees between the abutment and a tapered implant. A potential effect of embedment relaxation and/or manufacturing errors should be taken into consideration when selecting an abutment for a cement-retained crown on a tapered implant. Accordingly, clinicians may benefit from adjusting cement-retained implant crowns after re-torqueing the abutments to prevent potential occlusal and interproximal contact problems. Keywords: abutment, cement, dental implant, displacement, embedment relaxation, retention