Survey of Dental Clinicians for Attitude and Use of Torque-Limiting Devices

Chandur P.K. Wadhwani, Paul S. Rosen, Gang Yang, Wenjie Hu, Todd Schoenbaum, Tomas Linkevicius, Shankar Iyer, Timothy Hess, Mathew T. Kattadiyil, Kwok Hung Chung

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Purpose: The purpose of this study was to survey practicing clinicians and determine if differences existed concerning their use of torque-limiting devices (TLDs) and screw-tightening protocols, comparing this with existing universal industry standards. Materials and Methods: A nine-question survey was administered with 428 dentists providing data for three specific areas: (1) demographic information—TLD ownership, device age, frequency of use, and observations of screw loosening; (2) recognition information—calibration, reading measurements of the TLD, and the meaning of preload; (3) usage information—screw-tightening protocols and effect of speed during actioning of the TLD. Data collection was compared with industry standards for use of hand torque tools including ISO-6789 1,2:2017 and related texts pertaining to screw fastener protocols. Results: The beam-type TLD was the most popular; however, 33% surveyed used it incorrectly. Most TLDs being used were older than 1 year, with only 6% calibrated. Forty-eight percent observed screw loosening less than once per year, while 44% reported three or more occurrences per year. A similar number used the TLD for implant placement and abutment screw tightening. Screw-tightening protocols varied. Preload was not understood by the majority of those surveyed. Conclusion: Dentistry does not appear to adhere to the protocols and standards recommended by other industries that also rely on screw-fastening mechanisms and TLDs. Further education and training appears to be warranted in this area of implant dentistry to reduce the risks of screw-associated complications.

Original languageEnglish (US)
Pages (from-to)538-545
Number of pages8
JournalInternational Journal of Oral and Maxillofacial Implants
Issue number3
StatePublished - 2021
Externally publishedYes


  • abutment screw loosening
  • calibration
  • implant screws
  • preload
  • screw-tightening
  • torque-limiting device

ASJC Scopus subject areas

  • Oral Surgery


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