A dental torque wrench or restorative torque wrench is a torque wrench used to precisely apply a specific torque to a fastener bolt for fixation of an abutment, dentures or prosthetics [1] on a dental implant. [2]
Toggle torque wrenches (friction-style) and beam wrenches (spring-style) are the most common types in dentistry as manual mechanical torque-limiting devices. [3] Beam type wrenches in general are more consistent to its calibration than toggle types. The beam types with a dial indicator are the most precise to set the Tare torque (zero point reset). Because steam sterilization processes like an autoclave are applied to the dental torque wrenches and the length of time in use presents stress on the material, fatigue can occur. [4]
The surgical motor [5] is an electronic controlled torque-limiting device that also controls the speed. It is used with a twisted drill [6] to make space in the bone for the implant or to fasten the screw (torque control can be with a torque-limiting attachment) with a screwdriver bit.
In high precision areas such as aerospace applications motor or pneumatic torque wrenches are set at a lower torque value after which the final torque is set with a manual mechanical torque wrench, they are calibrated before every use, if a wrench breaks or loses calibration every fastener done with that wrench is redone.
Various studies point to deviations of 10% and higher than the desired torque, regular recalibration with a torque tester restores the required torque values. [7]
As the settling effect [8] (the flattening of the material's micro-surface under pressure) causes a lesser torque of around 10% in a relative short time, re-torquing the fastener after 10 minutes reduces this effect [9] as the parts get more seated.
Wet torques (bolts lubricated with saliva) have a higher mean torque than dry torques (unlubricated). [10]
A torque wrench is a tool used to apply a specific torque to a fastener such as a nut, bolt, or lag screw. It is usually in the form of a socket wrench with an indicating scale, or an internal mechanism which will indicate when a specified (adjustable) torque value has been reached during application.
A bridge is a fixed dental restoration used to replace one or more missing teeth by joining an artificial tooth definitively to adjacent teeth or dental implants.
A dental implant is a prosthesis that interfaces with the bone of the jaw or skull to support a dental prosthesis such as a crown, bridge, denture, or facial prosthesis or to act as an orthodontic anchor. The basis for modern dental implants is a biological process called osseointegration, in which materials such as titanium or zirconia form an intimate bond to the bone. The implant fixture is first placed so that it is likely to osseointegrate, then a dental prosthetic is added. A variable amount of healing time is required for osseointegration before either the dental prosthetic is attached to the implant or an abutment is placed which will hold a dental prosthetic/crown.
Osseointegration is the direct structural and functional connection between living bone and the surface of a load-bearing artificial implant. A more recent definition defines osseointegration as "functional ankylosis ", where new bone is laid down directly on the implant surface and the implant exhibits mechanical stability. Osseointegration has enhanced the science of medical bone and joint replacement techniques as well as dental implants and improving prosthetics for amputees.
In dentistry, a crown or a dental cap is a type of dental restoration that completely caps or encircles a tooth or dental implant. A crown may be needed when a large dental cavity threatens the health of a tooth. A crown is typically bonded to the tooth by dental cement. They can be made from various materials, which are usually fabricated using indirect methods. Crowns are used to improve the strength or appearance of teeth and to halt deterioration. While beneficial to dental health, the procedure and materials can be costly.
A dental drill or dental handpiece is a hand-held, mechanical instrument used to perform a variety of common dental procedures, including removing decay, polishing fillings, performing cosmetic dentistry, and altering prostheses. The handpiece itself consists of internal mechanical components which initiate a rotational force and provide power to the cutting instrument, usually a dental burr. The type of apparatus used clinically will vary depending on the required function dictated by the dental procedure. It is common for a light source and cooling water-spray system to also be incorporated into certain handpieces; this improves visibility, accuracy and overall success of the procedure. The burrs are usually made of tungsten carbide or diamond.
Toothlessness, or edentulism, is the condition of having no teeth. In organisms that naturally have teeth, it is the result of tooth loss.
Maxillary sinus floor augmentation is a surgical procedure which aims to increase the amount of bone in the posterior maxilla, in the area of the premolar and molar teeth, by lifting the lower Schneiderian membrane and placing a bone graft.
Dental instruments are tools that dental professionals use to provide dental treatment. They include tools to examine, manipulate, treat, restore, and remove teeth and surrounding oral structures.
Computer-assisted surgery (CAS) represents a surgical concept and set of methods, that use computer technology for surgical planning, and for guiding or performing surgical interventions. CAS is also known as computer-aided surgery, computer-assisted intervention, image-guided surgery, digital surgery and surgical navigation, but these are terms that are more or less synonymous with CAS. CAS has been a leading factor in the development of robotic surgery.
In dentistry, an abutment is a connecting element. This is used in the context of a fixed bridge, partial removable dentures and in implants. The implant fixture is the screw-like component that is osseointegrated.
Peri-implantitis is a destructive inflammatory process affecting the soft and hard tissues surrounding dental implants. The soft tissues become inflamed whereas the alveolar bone, which surrounds the implant for the purposes of retention, is lost over time.
Cone beam computed tomography is a medical imaging technique consisting of X-ray computed tomography where the X-rays are divergent, forming a cone.
The term All-on-4, also known as All‐on‐Four and All‐in‐Four, refers to 'all' teeth being supported 'on four' dental implants, a prosthodontics procedure for total rehabilitation of the edentulous (toothless) patient, or for patients with badly broken down teeth, decayed teeth, or compromised teeth due to gum disease. It consists of the rehabilitation of either edentulous or dentate maxilla and / or mandible with fixed prosthesis by placing four implants in the anterior maxilla, where bone density is higher. The four implants support a fixed prosthesis with 10 to 14 teeth, and it is placed immediately, typically within 24 hours of surgery.
Implant failure refers to the failure of any medical implant to meet the claims of its manufacturer or the health care provider involved in its installation. Implant failure can have any number of causes. The rates of failure vary for different implants.
Digital dentistry refers to the use of dental technologies or devices that incorporates digital or computer-controlled components to carry out dental procedures rather than using mechanical or electrical tools. The use of digital dentistry can make carrying out dental procedures more efficient than using mechanical tools, both for restorative as diagnostic purposes. Used as a way to facilitate dental treatments and propose new ways to meet rising patient demands.
Bicon Dental Implants is a privately owned company located in Boston, MA. The company specializes in short dental implants that use a locking taper or cold welding connection to secure the abutment to the implant. Bicon is notable and worthy of mention for the following three reasons: First, Bicon implants are extremely short in length. The size of Bicon implants allow them to be placed in regions that are crowded with natural teeth and/or implants, or in regions that would otherwise require bone grafting. Second, the implants do not have the screw-form design typical of other available implants. Third, the abutments are connected to the implant via a locking taper. This is notable from both a medical and engineering standpoint as no other implant company offers an implant with a biological seal at the implant/abutment interface; almost all other implants possess an internal screw to connect their abutments.
Hector L. Sarmiento is an American periodontist involved in dental implant complications research.
A root-analog dental implant (RAI) – also known as a truly anatomic dental implant, or an anatomical/custom implant – is a medical device to replace one or more roots of a single tooth immediately after extraction. In contrast to common titanium screw type implants, these implants are custom-made to exactly match the extraction socket of the specific patient. Thus there is usually no need for surgery.
A multi-unit abutment (MUA) is an abutment most commonly used with dental implants in "All-on-Four" protocols. They are designed for screw-retained group restorations, which are often used in combination with angled dental implants and whole arch replacements, as well as screw fixation of bridges made of zirconium or metal-ceramic group restorations to the implant.
