Browsing by Author "Kaffashian, Mahoor"
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- Assessment of maximum torque application in dental implantology : factors influencing practitioner performancePublication . Kaffashian, Mahoor; Correia, André Ricardo Maia; Araújo, Filipe Miguel Soares Framegas deIntroduction: The application of optimal torque is critical for the mechanical stability and long-term success of implant-supported prostheses. However, manual torque tightening is susceptible to variability due to operator experience, glove material, hand moisture, and instrument design. Inadequate torque delivery can lead to complications such as screw loosening, prosthetic instability, and eventual failure of the rehabilitation. This study aimed to investigate how these clinical and practitioner-related factors influence the maximum torque value (MTV) in implant dentistry. Materials and Methods: A pre-clinical laboratory study was conducted with 30 participants: 10 professors familiar with the area of implantology and 20 dental students of 4th and 5th year from FMD-UCP. Participants manually tightened prosthetic screws using Straumann® medium (21 mm) and long (27 mm) screwdrivers under six different glove and moisture combinations: nitrile gloves, latex gloves, and bare hands, each tested in both dry and wet environments. All torque values were measured using a calibrated bench torque meter. Descriptive statistics were used to summarize the data, followed by inferential analysis through ANOVA, Mann-Whitney, and Kruskal-Wallis tests to evaluate the effects of experience level, glove type, screwdriver length, and hand moisture on MTV, as well as to explore possible interaction effects between variables. Results: Professors achieved significantly higher torque values than students (mean = 16.92 Ncm Vs 15.03 Ncm; p = 0.01), confirming the influence of clinical experience. Glove type also significantly affected torque values (p = 0.01), with nitrile gloves yielding higher values (mean = 17.11 Ncm) than bare hands (mean = 14.20 Ncm; p = 0.008). This effect was significant among professors (p = 0.02) but not among students (p = 0.16). Although medium screwdrivers produced slightly higher torque values (16.33 Ncm) compared to long ones (14.99 Ncm), the difference was not statistically significant (p = 0.12). Dry hand conditions resulted in a higher mean torque (16.21 Ncm) than wet conditions (15.11 Ncm), but this was also not significant (p = 0.07). Conclusion: Clinical experience and glove type significantly influence the maximum torque applied in implant-supported prosthetic rehabilitation. Screwdriver length and hand moisture did not show statistically significant effects. Further studies should use calibrated torque devices with different mechanisms and assess how repeated use and time affect torque reliability and stability.
- Assessment of maximum torque in implant-supported prostheses: a pilot laboratory studyPublication . Kaffashian, Mahoor; Fazaeli, Seyedfarzad; Fialho, Joana; Araújo, Filipe; Fonseca, Patrícia; Correia, AndréBackground/Objectives: the precise application of torque during prosthetic screw tightening is essential to the long-term success and mechanical stability of implant-supported restorations. This study aimed to evaluate the influence of practitioner experience, glove material, screwdriver length, and hand moisture on the maximum torque value (MTV) generated during manual tightening. Methods: thirty participants, comprising 10 experienced professors and 20 senior dental students, performed tightening tasks under six hand conditions (nitrile gloves, latex gloves, and bare hands, each in dry and wet environments) using two screwdriver lengths (21 mm and 27 mm). The torque values were measured using a calibrated digital torque meter, and the results were analyzed using a linear mixed model. Results: professors applied significantly higher torque than students (16.92 Ncm vs. 15.03 Ncm; p = 0.008). Nitrile gloves yielded the highest torque (17.11 Ncm), surpassing bare hands significantly (p = 0.003). No statistically significant differences were found for screwdriver length (p = 0.12) or hand moisture (p = 0.11). Conclusions: these findings underscore the importance of clinical proficiency and glove material in torque delivery, providing evidence-based insights to enhance procedural reliability and training standards in implant prosthodontics.