Abstract
Background: Screw breakage and loosening are the most common mechanical complications in implant treatment. One of the causes is the excess or deficiency of the screw tightening torque; thus, the use of a torque wrench is a prerequisite for achieving an accurate tightening torque. Therefore, we focused on the beam-type torque wrenches, which are the main type, to clarify the factors affecting this torque.Results: The torque values of the beam-type torque wrenches for the eight manufacturers were measured using a torque gauge. For investigating the influence of the location of the beam placed on the scale, the measurement was performed with the scale aligned with the upper edge, center, and lower edge of the beam. Additionally, measurements were taken at 90°, 60°, and 30° to examine the effect of the angle at which the examiner read the torque value. Under each condition, a single examiner applied the recommended torque value of each manufacturer's screws five times clockwise. The average measured torque, standard deviation, bias, and coefficient of variation were calculated and compared. Equipment from six manufacturers demonstrated the best accuracy for measurements at the center of the beam (bias within ± 4%). For measurements at 90°, equipment from five manufacturers displayed the highest accuracy (bias within ± 7%), and seven showed the highest repeatability (coefficient of variation 2% or less).Conclusion: It was recommended that the center of the beam should be aligned with the scale and read from 90°, while tightening the torque wrench. The accuracy and repeatability differed according to the manufacturer, scale width, scale line width, and beam width, while the distance between scale and beam center was related to accuracy and repeatability. Based on these results, it was suggested that a torque wrench must be selected after grasping the difference depending on the structure of the model to be used.