Reliability and accuracy of the torque applied to osteosynthesis screws by maxillofacial surgeons and residents

Barzi Gareb*, Valerie D.M. van Munster, Pieter U. Dijkstra, Ruud R.M. Bos, Arjan Vissink, Nico B. van Bakelen, Baucke van Minnen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Applying the right torque to osteosynthesis screws is important for undisturbed bone healing. This study aimed to compare test-retest and intra-individual reliabilities of the torque applied to 1.5 mm and 2.0 mm osteosynthesis screws by residents and oral and maxillofacial surgeons (OMF-surgeons), to define the reference torque intervals, and to compare reference torque interval compliances. Five experienced OMF-surgeons and 20 residents, 5 of each 4 residency years, were included. Each participant inserted six 1.5 x 4 mm and six 2.0 x 6 mm screws into a preclinical model at two test moments 2 weeks apart (T1 and T2). Participants were blinded for the applied torque. Descriptive statistics, reference intervals, and intra-class correlation coefficients (ICC) were calculated. The OMF-surgeons complied more to the reference intervals (1.5 mm screws: 95% and 2.0 mm screws: 100%) than the residents (82% and 90%, respectively; P = 0.009 and P = 0.007) with the ICCs ranging between 0.85-0.95 and 0.45-0.97, respectively. The residents' accuracy and reliability were inadequate regarding the 1.5 mm screws but both measures improved at T2 for both screw types compared to T1, indicating a learning effect. Training residents and/or verifying the applied torque by experienced OMF-surgeons remains necessary to achieve high accuracy and reliability, particularly for 1.5 mm screws.

Original languageEnglish
Article number14411
Number of pages10
JournalScientific Reports
Publication statusPublished - 24-Aug-2022




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