Comparative Micro-CT Evaluation of Ball Attachment Compatibility in Implant and Analog Connections Using Hand Driver and Torque Wrench

English (OpenAlex)

Objectives: This study aimed to evaluate the effect of different tightening tools—a hand driver and a torque wrench—on the connection interface adaptation of ball attachments, at both the implant and analog levels, using micro-computed tomography (micro-CT). Materials and Methods: Twenty implants and twenty analogs from two implant systems (BioInfinity, Turkey and Dentis, Korea) were used, and a total of 40 ball attachments were evaluated. Each attachment was tightened using both a hand driver and a torque wrench at implant and analog levels. All samples were scanned using high-resolution micro-CT. To assess the compatibility of the implant/analog–ball attachment connections, linear measurements at the interface were performed. Statistical analysis included one-way ANOVA, Tukey’s HSD test, and independent samples t-test, with significance set at p < 0.05. Results: In the BioInfinity system, statistically significant differences were found both between implant and analog connections and between the two tightening methods (p < 0.05), with hand tightening often resulting in deeper seating. Conversely, in the Dentis system, no significant difference was observed between implant and analog interfaces, although the tightening method still had a significant effect (p < 0.05). Inter-system comparisons showed no statistically significant differences between the two systems regarding the effect of tightening tools. Conclusions: The connection interface adaptation in overdenture systems can be influenced by both the type of implant system and the method of tightening. Particularly for systems with lower manufacturing tolerances, discrepancies between implant and analog components should be considered. The choice of tightening tool plays a critical role in achieving optimal fit, which may affect the long-term success of overdenture prostheses. Further in vivo studies are recommended to validate these in vitro findings.