Influência do torque e da ciclagem mecânica na manutenção da pré-carga e resistência à fratura de parafusos de retenção em diferentes junções parafusadas
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Data
2016-06-17
Autores
Silva, Ebele Adaobi [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Sendo o afrouxamento e fratura dos parafusos de retenção as principais complicações em próteses implantossuportadas, este estudo teve como objetivo avaliar a manutenção do torque remanescente e ocorrência de fraturas em parafusos de retenção de pilares UCLA, para implantes de conexão hexagonal externa e cone Morse, em função do torque aplicado (recomendado pelo fabricante, torque obtido através de aperto manual e sem torque), submetidos à ciclagem mecânica. Sequencialmente, investigou-se a resistência à fratura desses parafusos por meio do teste de compressão em uma máquina de ensaio universal. Foram utilizados 36 implantes embutidos em poliuretano com uma inclinação de 30°, divididos em 6 grupos em função do tipo de conexão e do torque aplicado. De forma randomizada, os espécimes pertencentes ao grupo sem torque foram submetidos a ciclagem mecânica e os dos grupos torque recomendado pelo fabricante e torque manual foram submetidos a aplicação do torque e mensuração da pré-carga remanescente, antes (3 minutos após o aperto) e após a ciclagem mecânica (após 1x106 de ciclos). Ao fim da ciclagem, os parafusos foram submetidos ao teste de resistência a fratura por meio do ensaio de compressão, no qual foi aplicado uma carga de 5000N sob a velocidade de 0,5mm/min. Os resultados mostraram que em uma análise geral, o torque remanesce foi significantemente menor (p<0,05) após a ciclagem mecânica. Ao se comparar os dois tipos de conexão, não houve diferença em relação o torque remanescente (p>0,05). Para os diferentes tipos de torque, observou-se que quando se aplicou o torque recomendado pelo fabricante o torque remanescente foi significativamente maior (p<0,05) quando comparada ao grupo que recebeu o torque manual. Dos 36 parafusos de retenção dos pilares UCLA submetidos à ciclagem mecânica, 3 fraturaram, equivalendo a 8,33%. Submeteu-se ao teste de resistência a compressão 33 parafusos de retenção ciclados e 12 novos, sendo 6 para a conexão CM e 6 para a HE. Os parafusos novos apresentaram as maiores médias para a força máxima (116,80 Kgf) e também para deformação na força máxima (2,18 mm), havendo diferença estatisticamente significativa (p<0,05) ao se comparar com os parafusos ciclados. Comparando-se os tipos de conexão, os parafusos dos grupos de conexão Hexágono externo apresentaram a maior média de força máxima (FM). Dos 12 parafusos novos, 6 fraturaram durante o teste, sendo 3 de cada tipo de conexão. Já para os parafusos ciclados, houve a mesma quantidade de fratura, sendo 3 para a conexão cone Morse e 3 para a Hexágono externo. A maior média para força de ruptura (FR) ocorreu também nos parafusos novos. Conclui-se então que a ciclagem mecânica e os diferentes valores de torque de inserção, sendo estes abaixo do que se recomenda o fabricante, interferiram negativamente nos valores de torque remanescente dos parafusos de retenção das junções parafusadas nas condições avaliadas e embora os parafusos submetidos a ciclagem tenham apresentado uma menor média de força de ruptura, a diferença encontrada não apresentou poder estatístico que comprovasse sua influência na fratura dos parafusos de retenção testados.
Being loosening and fracture of retention screws the main complications in implant-supported prostheses, this study aimed to evaluate the preload maintenance and the occurrence of fractures at retention screws of UCLA-type abutment for implants with external hexagon connection and Morse Taper, due to the applied torque (recommended by the manufacturer, torque obtained by manual tightening and no torque), submitted to mechanical cycling. Sequentially, the fracture resistance of these screws was investigated by the compression test on a universal testing machine. Thirty-six implants embedded in polyurethane with an inclination of 30° were used and divided into 6 groups according to the type of connection and the applied torque. Randomly, the specimens belonging to the group without torque underwent mechanical cycling and groups of recommended by the manufacturer torque and manual torque underwent torque application and measurement of the remaining preload, before (three minutes after tightening) and after mechanical cycling (after 1x106 cycles). After cycling, the screws were submitted to the fracture resistance test by the compression test, which was applied a 5000N load under 0,5 mm/min speed. The results showed that in a general analysis, preload maintenance was significantly lower (p <0,05) after mechanical cycling. When comparing the two types of connection, there was no difference regarding to preload maintenance (p>0,05). For different types of torque, it was observed that, when it was applied the recommended by the manufacturer torque, the preload maintenance was significantly higher (p <0,05) compared to the group that received the manual torque. Of the 36 retention screws of UCLA-type abutments submitted to mechanical cycling, three fractured, being equivalent to 8,33%. Thirty three cycled retention screws, 12 new screw, being 6 for the CM connection and 6 for EH, were submitted to the compression strength test. The new screws showed the highest average for maximum strength (116,80 kgf) and deformation at full strength (2,18 mm), with a statistically significant difference (p <0.05) when compared with the cycled screws. Comparing the types of connection, the screws of the external hexagon connection groups had the highest mean maximum force (MF). Of the 12 new screws, 6 fractured during the test, being 3 of each type of connection. As for the cycled screws, there was the same amount of fracture, being 3 for the Morse Taper connection and 3 for the external hexagon. The highest average for fracture strength (FS) also occurred on the new screws. It was concluded that the mechanical cycling and different insertion torque values, which are lower than recommended by the manufacturer, negatively interfered on the preload maintenance of the retention screws of bolted joints in the evaluated conditions and although the screws submitted to cycling have presented a lower tensile strength average, the difference found did not present statistical power that would prove their influence on fracture of the tested retention screws.
Being loosening and fracture of retention screws the main complications in implant-supported prostheses, this study aimed to evaluate the preload maintenance and the occurrence of fractures at retention screws of UCLA-type abutment for implants with external hexagon connection and Morse Taper, due to the applied torque (recommended by the manufacturer, torque obtained by manual tightening and no torque), submitted to mechanical cycling. Sequentially, the fracture resistance of these screws was investigated by the compression test on a universal testing machine. Thirty-six implants embedded in polyurethane with an inclination of 30° were used and divided into 6 groups according to the type of connection and the applied torque. Randomly, the specimens belonging to the group without torque underwent mechanical cycling and groups of recommended by the manufacturer torque and manual torque underwent torque application and measurement of the remaining preload, before (three minutes after tightening) and after mechanical cycling (after 1x106 cycles). After cycling, the screws were submitted to the fracture resistance test by the compression test, which was applied a 5000N load under 0,5 mm/min speed. The results showed that in a general analysis, preload maintenance was significantly lower (p <0,05) after mechanical cycling. When comparing the two types of connection, there was no difference regarding to preload maintenance (p>0,05). For different types of torque, it was observed that, when it was applied the recommended by the manufacturer torque, the preload maintenance was significantly higher (p <0,05) compared to the group that received the manual torque. Of the 36 retention screws of UCLA-type abutments submitted to mechanical cycling, three fractured, being equivalent to 8,33%. Thirty three cycled retention screws, 12 new screw, being 6 for the CM connection and 6 for EH, were submitted to the compression strength test. The new screws showed the highest average for maximum strength (116,80 kgf) and deformation at full strength (2,18 mm), with a statistically significant difference (p <0.05) when compared with the cycled screws. Comparing the types of connection, the screws of the external hexagon connection groups had the highest mean maximum force (MF). Of the 12 new screws, 6 fractured during the test, being 3 of each type of connection. As for the cycled screws, there was the same amount of fracture, being 3 for the Morse Taper connection and 3 for the external hexagon. The highest average for fracture strength (FS) also occurred on the new screws. It was concluded that the mechanical cycling and different insertion torque values, which are lower than recommended by the manufacturer, negatively interfered on the preload maintenance of the retention screws of bolted joints in the evaluated conditions and although the screws submitted to cycling have presented a lower tensile strength average, the difference found did not present statistical power that would prove their influence on fracture of the tested retention screws.
Descrição
Palavras-chave
Prótese dentária, Implantes dentários, Torque, Falha de prótese, Prostheses and implants, Dental prosthesis, Torque, Prosthesis failure