Author ORCID Identifier

https://orcid.org/0009-0009-0295-811X

Semester

Spring

Date of Graduation

2026

Document Type

Thesis

Degree Type

MS

College

School of Dentistry

Department

Restorative Dentistry

Committee Chair

R. Constance Wiener

Committee Member

Shelby Alexander

Committee Member

Jennifer Franko

Abstract

Evaluation of Finger-Tightening Torque Applied to Implant Healing Abutments by Dental Providers with Varying Experience and Physical Characteristics: An In-vitro Study

Bayan Abuhalimeh, D.D.S

Aim: The primary objective of this project is to measure the actual torque applied by dental providers when finger-tightening a healing abutment and assess the variability among individuals. A secondary objective is to analyze the correlation between applied torque and: provider experience level (residents, general dentist, specialist); gender; age; and, physical attributes (e.g., grip strength, hand size, and dominant hand used for tightening). The null hypothesis is that there is no difference in the mean finger-tightening among the three groups of dental providers, and there are no significant differences in torque values among practitioners based on demographic and professional variables. The alternative hypothesis is that there is a significant difference among dental providers with varying experience and physical characteristics.

Methods: Twenty-five providers (n = 25) with varying levels of clinical experience including residents, general practitioners, and specialists were recruited. Each participant was instructed to finger-tighten a ZimVie healing abutment into a securely clamped implant fixture in a manner consistent with their routine clinical practice. The applied torque was measured and recorded using a digital torque device (Cedar DID-4A). In addition, participants completed a short, anonymous questionnaire designed to collect demographic and professional data, including age, gender, dominant hand, professional status, and years of clinical experience. Information regarding prior implant experience, hand-related physical characteristics (e.g., glove size, presence of musculoskeletal conditions, and engagement in hand-intensive activities), as well as participants’ perceived confidence and decision-making process during finger tightening, was also obtained.

All statistical analyses were performed using SPSS software. Data were analyzed using appropriate non-parametric tests. Statistical significance was set at p < 0.05.

Results: The mean torque value recorded was 21.32 ± SD 6.98 Ncm, with a median of 19.05 Ncm (minimum, 12.19 Ncm, maximum, 37.56 Ncm). Repeated measures analysis using the Friedman test demonstrated no statistically significant difference between sequential torque applications (p =0.350). Group comparisons using the Mann–Whitney U test revealed no statistically significant differences in torque values based on gender (p = 0.285), hand size (p = 0.640), engagement in weightlifting or intensive physical activity (p = 0.403), years of clinical experience (p = 0.810), specialty (p = 0.182), professional status (p = 0.670). In addition, no significant association was found between torque values and age (Spearman correlation, p = 0.875; Kendall’s tau, p= 0.925). Overall, torque values were consistent across participants, with no variable demonstrating a statistically significant effect.

Conclusion: Within the limitations of this study, finger tightening of healing abutments resulted in consistent torque values across repeated trials and among operators with varying demographic and professional status. No statistically significant factors influencing torque application were identified, suggesting that finger-applied torque may be largely operator-independent. These findings indicate that finger tightening may provide a reproducible level of torque in clinical practice; however, further studies with larger sample sizes are recommended to confirm these results and to better evaluate potential influencing factor

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