Pick your implant brand and component. Get the recommended torque, screw type, driver, and tightening protocol.
Implant brand
Nobel Biocare
Straumann
Zimmer Biomet
BioHorizons
Neodent
MIS
Osstem
Megagen
Hiossen
Component
Implant placementSurgical insertion
Healing abutmentHealing abutment
Definitive abutmentDefinitive abutment
Prosthetic screwProsthetic screw
Multi-unit abutmentMulti-unit abutment
Frequently asked questions about implant torque
Insertion torque varies by manufacturer and bone density. Most systems recommend 30 to 45 Ncm for placement, though some like Straumann BLX allow up to 70 Ncm for immediate loading. In D1 bone (very dense) use the low end of the range; in D3-D4 (soft) aim for at least 35 Ncm to achieve adequate primary stability.
Prosthetic screw settling (settling effect) happens in the first minutes after tightening. Re-torque compensates for screw relaxation and significantly reduces the risk of loosening. Studies show preload can drop by up to 10% in the first 10 minutes if re-torque is not performed.
Exceeding maximum torque can cause screw fracture, deformation of the implant internal connection, or microfractures in peri-implant bone that compromise osseointegration. In prosthetic screws, over-torque can permanently deform the thread, leading to preload loss and recurrent loosening.
No. The abutment screw typically requires higher torque (25-35 Ncm) than the prosthetic screw (10-20 Ncm). Using the wrong torque is a frequent cause of mechanical complications. Always check the manufacturer's specifications for each component.
Use the manufacturer's calibrated torque wrench. Universal wrenches may have different tolerances. If you use a universal wrench, it must be calibrated periodically and verified with the system-specific drivers. Annual calibration is the standard recommendation.
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Tightening torque in implantology is not a suggestion — it is an engineering spec calculated to generate the correct preload at the screw-implant joint. Any deviation from the specified value compromises mechanical stability of the restoration and the health of the peri-implant tissue.
What an Ncm (Newton-centimeter) is
The torque unit used in implantology. 1 Ncm equals applying 1 Newton of force at 1 centimeter from the axis of rotation. Typical values for abutment screws run 15 to 35 Ncm. For prosthetic screws, 10 to 20 Ncm. Each manufacturer specifies the exact value for each component.
Preload: the physics behind torque
Torque is not the goal — it is the means to generate preload (axial tension in the screw). Correct preload keeps contact surfaces compressed, resisting separation forces during chewing. Only about 10% of the applied torque converts into preload — the other 90% is lost to friction.
Settling effect: why screws loosen
The metal surfaces of the screw and implant have micro-irregularities. Under functional load, these irregularities flatten (settling), reducing preload 2-10% in the first few hours. That is why most manufacturers recommend re-torque at 10 minutes.
The correct torque protocol in 4 steps
1
Verify the manufacturer's value
Before tightening any screw, check the manufacturer's specifications for that specific component. The abutment screw may require 35 Ncm, but the prosthetic screw in the same system may only need 15 Ncm. Applying 35 Ncm to a 15 Ncm screw fractures it inside the implant — a complication that can require surgery to resolve.
2
Use a calibrated torque wrench
Digital torque with a calibrated wrench is the only reliable method. Finger-tight generates only 5-10 Ncm — not enough for proper preload. Manual click wrenches need periodic calibration (every 6-12 months or every 500 cycles). An uncalibrated wrench can apply ±20% of the indicated value.
3
Re-torque at 10 minutes
After the initial torque, wait 10 minutes and apply the same value again. The settling effect during those minutes reduces preload significantly. Re-torque compensates for that loss and establishes stable preload. Studies show re-torque reduces screw loosening rates by 50-70%.
4
Document and seal
Record in the chart: component used, screw lot, torque value applied, and re-torque time. Seal the screw access with removable material (PTFE tape + composite) that allows future access without damaging the restoration. Avoid permanent cements over screw access holes.
5 torque mistakes that cause avoidable complications
1
Finger-tightening instead of using a calibrated wrench
Finger-tight consistently generates only 5-10 Ncm when the manufacturer specifies 25-35 Ncm. That leaves the joint with less than 30% of the required preload. The result: screw loosening in weeks or months, especially in the posterior where chewing forces run 200-400 N.
2
Skipping the 10-minute re-torque
The settling effect loses 2-10% of preload in the first minutes. Without re-torque, the joint starts suboptimal and only gets worse with use. It is a 30-second step that drops loosening rates dramatically. Skipping re-torque is like putting on a tire without checking the pressure.
3
Using the wrong driver
Every implant system has specific drivers (hex 1.25mm, hex 0.9mm, square, star). A driver that does not fit perfectly rounds out the screw hex, blocks torque transfer, and can leave the screw impossible to remove. Always use the system's original driver.
4
Applying abutment torque to the prosthetic screw
The abutment screw (which fixes the abutment to the implant) typically requires 25-35 Ncm. The prosthetic screw (which fixes the crown to the abutment) typically requires 10-15 Ncm. Mixing these up and applying 35 Ncm to a 15 Ncm prosthetic screw fractures the screw or deforms the internal threads of the abutment.
5
Never calibrating the torque wrench
Mechanical torque wrenches (click or friction) lose accuracy with use. A wrench that reads 30 Ncm but actually applies 22 Ncm creates chronic under-torque across every case you do. Electronic wrenches are more accurate but more expensive. Either way, periodic calibration is not optional.
Frequently asked questions about implant torque
The metal surfaces of the screw and implant have micro-roughness that flattens under pressure (settling effect). This reduces preload 2-10% in the first minutes. Re-torque compensates for that loss and establishes stable final preload. Studies by Jaarda et al. and Siamos et al. demonstrate that re-torque at 10 minutes significantly reduces long-term screw loosening incidence.
No. Maximum torque is calculated to stay within the elastic limit of the screw material (typically grade 5 titanium, Ti-6Al-4V). Exceeding it causes permanent plastic deformation: the screw stretches and loses its ability to hold preload. In severe cases the screw fractures inside the implant — removal can require specialized extraction kits or even compromise the implant itself.
If the fragment sticks out, you can try to remove it with hemostats or an explorer turned counter-clockwise. If it is flush, use broken screw extraction kits (Nobel, Straumann, or generic ones) that drill the center of the fragment and pull it out with a reverse extractor. If nothing works and the internal threads are damaged, the implant can become unusable. Prevention: never exceed maximum torque and replace used screws.
Prosthetic screw torque does not change — it is a fixed mechanical spec of the component. What changes is the implant insertion torque. For immediate loading you target insertion torque ≥35 Ncm (ISQ ≥65) as an indicator of sufficient primary stability. With insertion torque below 25 Ncm, immediate loading carries higher failure risk and a conventional protocol is recommended (wait 3-6 months).
Mechanical wrenches (click type) should be calibrated every 6-12 months or every 500 use cycles, whichever comes first. Electronic wrenches have self-calibration but still need annual verification. Signs your wrench needs calibration: the click feels different, the wrench does not “click” cleanly, or you notice frequent screw loosening. Some manufacturers offer free calibration with component purchases.
The right torque is not a guess
Every implant, every screw, every component has a specific value. TrazaLab centralizes the specs so you never have to dig through manuals.