A universal torque wrench system.

aAssociate Professor, Department of Clinical Sciences, School of Dental Medicine, University of Nevada Las Vegas. bProfessor, Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, Ohio. (J Prosthet Dent 2012;108:401-403) 1 Instrument kit with available inserts, from left to right: 0.050in. hexagon straight (Zimmer part # HX1.25D), 0.048-in. 24 mmL hex (Biomet 3i part # RASH3N), 0.048-in. 30 mmL (Biomet 3i part # RASH8N), 6-point star 20 mmL (Straumann part # 046.410), 6-point star 26mmL (Straumann part # 046.411), unigrip star 20 mmL (NobelBiocare part # 29151), unigrip star 25 mmL (NobelBiocare part # 29152), 4-lobe star 22 mL (Thommen part # 3.03.501), locator (Biomet 3i part # LOADT4), 0.035-in. hexagon 24 mmL (Biomet 3i part # RASH2N). Legend: ZI = Zimmer Dental, AST = AstraTech, 3i = Biomet 3i, STR = Straumann, NB = NobelBiocare, THM = Thommen, LOC = Locator. Dental implant manufacturers supply various forms of torque limiting devices for use with implant restorations. A clinician may use these instruments to ensure adequate torque delivery with appropriate precision.1-4 Throughout the early period of dental implant prosthetics, screw loosening was a major complication,4-8 but a later study found that while screw loosening remained a potential prosthetic complication, it was less common than the early studies suggested.9 Nevertheless, inadequate tightening with insufficient torque has been cited as a possible reason for screw loosening.10 Two major categories of torque limiting devices for use in implant dentistry are available: friction-style and spring-style. Friction-style devices are hexagon wrenches with a handle that releases when a desired torque value is reached. Spring-style devices have torque levels marked on an incremental scale, and the operator applies a force on the spring until the appropriate torque level is reached. Spring-style devices have been reported to be significantly more accurate than friction-style devices.11 Spring-style torque limiting devices have been adapted to multiple implant systems,12 which has simplified dental implant prosthetics. The technique, however, had limited torque control because of the lack of an incremental scale, allowing the operator to deliver torque values other than the preset 0, 15, and 35 Ncm. Since 1999 when this technique was published,12 substantial changes in implant systems have occurred and updates to the technique are indicated. The purpose of this article is to describe a universal implant torque kit that would allow an operator to provide precise torque values to implant components from various dental implant manufacturers. PROCEDURE