implant systems , which are well known in the art , generally consist of an implant or fixture , which is surgically implanted into a patient &# 39 ; s upper or lower jawbone . as shown in fig1 and fig1 a , the fixture 10 includes an externally threaded body 12 , which is surgically screwed into the jawbone . at one end of the body is a flange 14 , which has bearing surface 16 . body 12 of fixture 10 includes an internal bore 18 , which extends from the flange 14 and which is at least partially threaded to receive an abutment screw ( also known as a spacer screw ) 22 , which includes a threaded portion 24 , and a head 26 . an abutment 30 includes a bearing surface 32 , which forms a joint 34 with the bearing surface 16 of flange 14 . abutment 30 also includes an internal bore 36 to receive screw 22 and a flange 38 which is smaller in diameter than the head 26 of abutment screw 22 . the abutment screw 22 passes through the bore 36 of abutment 30 , and the threaded portion 24 of abutment screw 22 mates with the internal threads 20 of internal bore 18 of the fixture 10 . abutment screw 22 is screwed into the internally threaded bore 18 of fixture 10 , and tightened to a predetermined pre - load to secure the abutment 30 to the fixture 10 . head 26 of the abutment screw 22 is provided with an internal bore 40 which has a geometric shape , such as an internal hex , adapted to receive a tool such as a hex wrench for tightening the screw . other geometric shapes for tools are well known in the art . the abutment screw used for practicing the invention is provided with a reflecting surface at the bottom 42 of bore 40 . a second reflecting surface 44 is provided at the opposite end of the screw . each reflecting surface is preferably generally flat , and generally perpendicular to the line of transmission of the sonic pulse . any number of screw head designs may be used , so long as each end of the screw ( heads and ends ) has a reflecting surface that is sufficiently perpendicular to the ultrasound propagation pathway in order to register and record at a sufficient amplitude the time of flight between two acoustical impulses traveling the length of the screw . all dental implant screw designs can potentially be modified to create a sufficiently reflecting area within and at the base of the head alteration and also at the end of the screw for this purpose . alternatively , other forms of reflecting surfaces may be used . in one embodiment of the invention depicted in fig1 , a small 20 mhz pzt element ( transducer ) 50 of 0 . 8 mm diameter is fixed to a flattened area 42 in the head 26 of a screw 22 . this transducer 50 provides the interface between the screw 22 and an acoustic source 70 ( see fig2 ) for the transmission of an acoustic pulse along the long axis of the screw . as shown in fig7 and fig2 , the acoustic source is a hand held wand 70 that is electronically connected to a control box 72 . the electronic connection may be hard - wired 74 , or it may be accomplished remotely , such as by infrared or by so - called “ bluetooth ” technology , so long as the wand is provided with appropriate infrared transmission and / or receiving means . alternatively , the control box can be provided in miniaturized form through microelectronics entirely within the handle 76 of the wand 70 . within the control box 72 are the electronics needed to initiate an ultrasonic impulse from an acoustic source 78 near the small tip 82 of the wand 70 . the tip 82 of the wand 80 is placed in contact with the transducer element 50 in the head 26 of the screw 22 , which clamps together the abutment 30 and implant 10 to form the screw joint 38 of the implant assembly . a sound impulse is initiated from the tip 82 of the wand 80 and the sound is transmitted by the transducer 50 in the screw head 26 to the opposite end 44 of the screw 22 . two clear sequential echo - pulses are reflected from the screw bottom ( end ) back to the transducer and ultimately across the interface to the wand . the time of flight between pulses 1 and 2 can be determined independent of the acoustic contact variations . the time of flight of the wave propagation through the screw is registered by the transducer 50 and the information is transmitted and processed in the control box 72 by a computer microchip . tightening of the screw will produced variations in screw length related to the elastic properties of the screw . screw length variations influence the time of flight of the ultrasonic pulse along the long axis of the screw . the differences in the time of flight recorded before and after screw tightening are used to compute the stress within the screw as a function of screw tightening . the stress is computed by the control box electronics , and displayed both graphically and digitally at the control box 72 . as shown schematically in fig2 , a system for preload measurement may include , for example , an embedded 20 mhz ultrasonic transducer 50 , an ultrasonic pulser - receiver usd - 15 ( krautkramer ) 72 , a digitizing oscilloscope tds - 520 ( tektronix ) 73 connected to a gpib port ( ieee488 ) 75 with computer 77 . as is discussed above , the implant screw is provided with a generally flattened surface inside the tool - receiving bore in order to accommodate a 1 mm diameter piezoelectric piston . a piezoelectric disk 50 is positioned inside the screw head and two wires soldered in order to provide the electric path . to protect the piezoelectric element and the wiring the head was molded with epoxy compound . the setup immediately provided two clear echo - reflections from the opposite end of the screw . to increase amplitude of the reflected signals the threaded end of the screw was slightly flattened . in fig3 a typical a - scan is given . the basics of the measurement consist of determining variation of the delay between 1 st and 2 nd reflections . to measure the tof between the two pulses zero cross - section method is used . the software seeks for the first minimum of both signals and then calculates the time coordinate of next zero cross - section linearly interpolating the signal between two consecutive samples for both first and second echo - pulses and finally estimates tof as given by the following formula . tof = 1 f sampl ⁢ ( i - j + ( wfm ⁡ ( i ) wfm ⁡ ( i ) - wfm ⁡ ( i + 1 ) - wfm ⁡ ( j ) wfm ⁡ ( j ) - wfm ⁡ ( j + 1 ) ) ) , ( 1 ) where f sampl is the sampling frequency , wfm ( k ) is the digitized waveform data , i , j are samples around zero crossing ( see fig4 ). better results are obtained at 1 ghz sampling rate . a real - time measurement provides ± 0 . 2 ns precision , with 32 - average mode the precision goes to 0 . 02 ns . this corresponds approximately to 0 . 025 ° c . temperature variation , or 0 . 6n force variation using for approximation elastic parameters of mild steel . exact values of these uncertainties are to be calculated after the stress - tof and temperature - tof characteristics are studied for the material used in manufacturing the screw . this system results in excellent resolution of the method . to realize the measurement method a software program may be used . basic features of the program are transfer of the digitized a - scan from tds520 to a personal computer , serial port communication , time delay compensation and measurement , and data storage . the outlook of a program window is given in fig5 . configuration windows for the preload gauge are shown in fig6 . in another embodiment , depicted in fig8 , wand 90 is designed to transmit and receive acoustic and time of flight data without the need for contact between the wand tip and a transducer located in the head of the screw . in this embodiment , the transducer 50 is positioned within the tip 92 of the wand , near enough to the end to transmit and detect sonic impulses . the wand also incorporates technology for digital analog signals to be transmitted and received in order to carryout the functions identified in the hard - wired control box . the information received and transmitted by the wand may be displayed in a remotely located display mode . in another embodiment , the ultrasonic transducer may be located within the tool used to tighten the screw . thus , a screwdriver may be used to tighten the screw and either simultaneously or at the end of the torquing procedure measure the stress within the screw . one end of the screwdriver is formed in a well known latch - type design for attachment to an electronic or manual tightening torque apparatus . at the other end of the screwdriver , the ultrasonic transducer is positioned within the screwdriver end in a position permitting it to transmit and detect sonic impulses . the transducer is electronically connected to the latch - type end by internal circuitry . the transducer is electronically connected to either the electronic or manual tightening torque handpiece by an electronic interface within the handpiece head . the screwdriver is positioned in the screw bore and brought into intimate contact with the screw . following initiation of the sound impulse , the sound travels through the screw to the end of the screw . in the electronic tightening torque apparatus , the time of flight of the wave propagation through the screw is registered by the transducer in the screw driver , and the information is transferred electronically back to the tightening torque apparatus control boxes or an associated display unit . the elastic properties of the screw , which have been altered by the torquing force used to tighten the screw , are displayed both graphically and digitally at the control box ( 6 ) as the preload . in the case of the manual tightening torque apparatus , the electronics for initiation of the wave impulse from the screwdriver , and data retrieval and processing are located in a modified handle for the tightening torque apparatus . the registration , recording and computation of the time of flight are performed using micro - processing technology and transferring the information from the electronic port in the manual tightening torque handle ( 2 ) as a digital analog signal to a remote display unit .
a method and apparatus are provided for determining the preload in a dental implant system . the preload is determined by transmitting a sonic impulse , which is preferably an ultrasonic impulse , at a predetermined frequency to the head of the implant screw through a transducer , which may be incorporated into the head of the screw , the head of a wand which generates the sonic impulse , or the transducer and pulse - generating instrumentation may be incorporated into a torque generating instrument used to tighten the screw . the preload is determined by measuring the delay between the first and second reflections through the preloaded screw to determine a preload value and comparing that value with a pre - established baseline value for the screw , and comparing the difference with a predetermined table of values to determine the preload on the screw .