title: Intended and Achieved Torque of Implant Abutment's Screw using Manual Wrenches in Simulated Clinical Setting.
abstract: OBJECTIVE
  To measure the difference between the intended torque and the achieved torque by the operator using the spring-style mechanical torque-limiting device (MTLD).
  
  
  METHODS
  Inexperienced and experienced clinicians used one spring-type MTLD to torque two abutment screws of each anterior and posterior implants, which were attached to two digital torque meters through a jaw model. The jaw model was part of a preclinical bench manikin attached to a dental chair. The intended torque value was 35 N cm (recommended by manufacturer) and the technique of torquing was observed for all the participants (instantaneous and repeated). The mean torque value was calculated for each subject for the anterior and posterior implants independently; t-test was used to compare between the intended and achieved torque values and to compare between the experienced and inexperienced clinicians (p ≤ 0.05).
  
  
  RESULTS
  Thirty-seven clinicians participated, with an overall mean torque value of 34.30 N cm. The mean torque value of the achieved torque (34.30 ± 4.13 N cm) was statistically significantly less than the intended torque (p = 0.041). The male clinicians produced more statistically significantly accurate torque value (34.54 ± 3.78 N cm) than the female clinicians (p = 0.034), and the experienced clinicians produced more accurate torque values (34.9 ± 5.13 N cm) than the inexperienced clinicians (p = 0.048).
  
  
  CONCLUSIONS
  Within the limitation of this study, the use of MTLDs did not always produce consistent torque values and the technique by which the operators use the MTLD might affect the torque value.
authors.affiliation: Department of Prosthetic Dental Sciences, College of Dentistry King Saud University, Riyadh, Kingdom of Saudi Arabia, Phone: +966114677325, e-mail: dr.hanan.alotaibi@gmail.com.
authors.forename: Hanan N
authors.initials: HN
authors.lastname: Al-Otaibi
mesh_terms: D000044:Dental Abutments; D003748:Dental Equipment; D003758:Dental Implantation, Endosseous / Q000295:instrumentation*; D015921:Dental Implants; D017267:Dental Prosthesis Design; D017268:Dental Prosthesis Retention / Q000295:instrumentation; D019094:Dental Prosthesis, Implant-Supported / Q000295:instrumentation*; D003799:Dental Stress Analysis / Q000379:methods; D004867:Equipment Design; D006801:Humans; D007180:Incisor; D008422:Materials Testing; D008963:Molar; D000066908:Simulation Training; D013674:Technology, Dental / Q000295:instrumentation*; D019415:Torque
chemical_list: D015921:Dental Implants
keywords: Dental implant; Manual wrenches; Screw loosening Torque.