Hello, could you please advise me?I have done my first implant.When I placed the healing abutment I used a torque wrench on 10 N.cm to be sure it wouldn´t become loose. When I wanted to replace it with a scan body, I tried to use only a srewdriver and it was very tight so I took a torque wrench to help and the healing abutment came outside together with my implant and they were conected quite tight!!!
So i´ve got a few questions-can I use a torque wrench or better not when srewing a healing abutment?
Does it mean that the implant was not fully osseointegrated when it came out with the healing abutment relatively easily?
Assuming that you allowed an adequate amount of time for integration it is safe to conclude that your implant just failed but as a general rule I just place my healing abutments with a hand driver to a snug position. There have been studies done and I think the average person is capable of achieving somewhere between 10-15Ncm using a hand driver so even though you used a torque wrench it doesn’t appear that you overtorqued it. Be careful though because a lot of the better connections will achieve a cold weld at the abutment interface causing the reverse torque to be greater than the original insertion torque of the component attached to the fixture.
I agree with Scotty’s reply, I always hand tighten tissue abutments. In the old days, like early 2000’s we would put neosporin on healing abutment to “avoid” a cold weld. I don’t know if it made a difference, but I don’t remember any cold weld issues. My .02.