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Content Menu
● Introduction to Atlantis Abutments
>> Atlantis Angulated Screw Access Abutment
● Importance of Correct Torque
>> Consequences of Incorrect Torque
● Atlantis Abutment Screw Torque
● Angulated Screw Access and Torque
>> Challenges with Angulated Screws
● Impact of Screw Design on Torque Efficiency
● Tightening Protocols for Implant Abutments
● Insertion Torque and Implant Success
● Effects of Cyclic Loading on Torque
>> 1. What is the recommended torque for Atlantis abutments?
>> 2. How does incorrect torque affect the stability of dental implants?
>> 3. What are the consequences of over-tightening abutment screws?
>> 4. How does the angulated screw access feature impact torque application?
>> 5. What tools are necessary for tightening Atlantis abutment screws?
Dental implants have become a popular solution for tooth loss, offering a durable and natural-looking alternative to traditional dentures. However, the success of these implants depends on several factors, including the proper application of torque during the installation of abutment screws. Incorrect torque can lead to complications such as screw loosening, microgaps, and ultimately, implant failure. This article will explore the importance of correct torque application for Atlantis abutment screws and the potential consequences of incorrect torque.
Atlantis abutments are designed to provide a stable base for dental restorations, ensuring a secure fit between the implant and the crown. These abutments are available in various materials, including titanium and zirconia, and are compatible with several implant systems. The Atlantis system offers flexibility with its angulated screw access feature, which allows for more versatile restoration designs.
The Atlantis Angulated Screw Access Abutment is particularly useful in situations where the implant is placed at an angle that would otherwise complicate the restoration process. This feature enables the creation of screw-retained restorations even when the implant's position is not ideal. The abutment includes a special screw that requires a unique driver, ensuring that the screw can be tightened at an angle without compromising the restoration's integrity.
Applying the correct torque to abutment screws is crucial for maintaining the stability and longevity of dental implants. The recommended torque values are typically provided by the implant manufacturer and should be followed precisely. Using a torque-control device ensures that the screw is tightened to the specified level without over- or under-tightening.
- Screw Loosening: Insufficient torque can lead to screw loosening over time, which may result in bacterial colonization along the abutment-implant junction, crestal bone loss, and potential fracture of the screw or abutment.
- Microgaps and Microleakage: Excessive torque can cause plastic deformation of the screw, leading to microgaps at the implant-abutment interface. These gaps can allow bacteria to enter, potentially causing peri-implantitis.
- Implant Failure: High insertion torque can lead to over-compression and bone necrosis, compromising the long-term stability of the implant.
Atlantis abutments typically use the same torque and driver settings as the original implant manufacturer. For example, Astra implants often require a torque of 20-35 Ncm, depending on the specific implant model. It is essential to consult the manufacturer's guidelines for the precise torque value to ensure optimal performance.
1. Initial Tightening: The abutment screw should be tightened with light finger force initially to ensure proper seating.
2. Final Tightening: Use a torque-control device to achieve the recommended torque level. This step is critical for maintaining the stability of the restoration.
The angulated screw access feature in Atlantis abutments allows for more flexibility in restoration design. However, it requires a specialized screwdriver to ensure proper torque application at an angle. The unique design of these screws and drivers ensures that the torque is applied effectively, even when the screw channel is not aligned with the implant axis.
- Torque Loss: When screws are tightened at an angle, some of the applied torque may be lost due to the non-axial loading. This can affect the clamping force and potentially lead to screw loosening over time.
- Screw Design: The design of the screw head and the driver interface is crucial for maintaining torque efficiency at different angles. Atlantis abutments are designed to minimize torque loss while ensuring secure tightening.
The design of the abutment screw plays a significant role in maintaining torque efficiency. Factors such as surface roughness and screw geometry can affect the preload achieved during tightening. A higher surface roughness can increase friction, reducing the effective preload for a given torque, which may lead to increased screw loosening over time. The Atlantis abutment screws are anodized to reduce friction, thereby enhancing the preload achieved during tightening[1].
Recent studies have emphasized the importance of optimal tightening protocols for implant abutments. A common protocol involves tightening the screw to the recommended torque and then retightening after a short interval, typically 10 minutes. This approach helps maintain the clamping force by compensating for the settling effect that occurs as the screw and implant surfaces adjust[3].
- Initial Tightening: Tighten the screw to the recommended torque using a torque-control device.
- Retightening: After 10 minutes, retighten the screw to ensure optimal clamping force and minimize screw loosening.
Insertion torque is another critical factor in dental implant success. It contributes to primary stability, which is essential for osseointegration—the process by which bone integrates with the implant. High insertion torque can provide greater primary stability but may also lead to complications such as bone necrosis if excessive[4][7].
- Primary Stability: Higher insertion torque generally results in greater primary stability, which is beneficial for immediate loading.
- Bone Quality: The optimal insertion torque depends on bone quality and density. Higher torque may be appropriate in denser bone but could be detrimental in softer bone.
Cyclic loading, which simulates chewing forces, can affect the torque of abutment screws over time. Studies have shown that angulated screw channels may experience significant torque loss under cyclic loading conditions, which can compromise the stability of the restoration[6].
A recent study compared the torque loss of angulated screw channels on narrow-diameter implants. The results indicated that the Atlantis Custom Base Solution with angulated screw access experienced a higher percentage of torque loss compared to other systems, highlighting the need for careful consideration of screw design and loading conditions[6].
Incorrect torque on Atlantis abutment screws can indeed lead to implant failure by causing screw loosening, microgaps, and excessive stress on the implant-abutment interface. It is crucial to follow the manufacturer's recommended torque values and use appropriate tools to ensure the longevity and stability of dental implants. Regular monitoring and maintenance are also essential to prevent complications and ensure the success of the restoration.
The recommended torque for Atlantis abutments typically matches the specifications of the original implant manufacturer. For example, Astra implants often require a torque between 20-35 Ncm.
Incorrect torque can lead to screw loosening or excessive stress on the implant-abutment interface, potentially causing microgaps and compromising the long-term stability of the implant.
Over-tightening can cause plastic deformation of the screw, leading to microgaps and potentially reducing the fatigue life of the screw and the restoration.
The angulated screw access feature requires specialized drivers to ensure proper torque application at an angle. While it offers design flexibility, it may result in some torque loss due to non-axial loading.
A torque-control device and a screwdriver sourced from the implant manufacturer (or an Angulated Screw Access driver for angled restorations) are necessary for tightening Atlantis abutment screws.
[1] https://www.nature.com/articles/d42473-018-00300-z
[2] https://dentistpeshawar.pk/dental-implants/dental-implant-torque-values/
[3] https://acodent.academy/wp-content/uploads/2024/07/jpd-2021.pdf
[4] https://www.ijpi.in/journal-article-file/6317
[5] https://pmc.ncbi.nlm.nih.gov/articles/PMC7046827/
[6] https://pubmed.ncbi.nlm.nih.gov/37689572/
[7] https://ziacom.com/en/torque-values-in-implant-dentistry-causes-of-failure-and-tips-for-their-correct-application-2/
[8] https://ipd2004.com/media/files/formacion/A_Comprehensive_Guide_to_Screw_Tightening_Techniques_3.pdf
[9] https://pmc.ncbi.nlm.nih.gov/articles/PMC10092009/
[10] https://www.mdpi.com/2077-0383/12/3/855
[11] https://classiccraftdental.com/wp-content/uploads/2019/08/Atlantis-abutments-Screw-torque-recommendations.pdf
[12] https://pmc.ncbi.nlm.nih.gov/articles/PMC10058042/
[13] https://pmc.ncbi.nlm.nih.gov/articles/PMC7842481/
[14] https://www.jomos.org/articles/mbcb/full_html/2022/04/mbcb210218/mbcb210218.html
[15] https://www.ijpi.in/html-article/19960
[16] https://www.dentsplysirona.com/content/dam/master/product-procedure-brand-categories/implant-dentistry/product-categories/ifu/4498/IMP-IFU-Atlantis-Abutments-Crowns-and-Insertion-Guides-EN-4498-2024-03.pdf
[17] https://bicon.com/cms/wp-content/uploads/2024/09/3-dr-sushil.pdf
[18] https://www.linkedin.com/pulse/comprehensive-guide-screw-tightening-techniques-francesco-biaggini-sllnf
[19] https://www.mdpi.com/2673-1592/7/1/9
[20] https://workflows.orderdigitalsolutions.com/pdf/Atlantis%20Design%20guide%20abutments%20and%20crown.pdf
