Effect of Abutment Screw Design and Crown/Implant Ratio on Preload Maintenance of Single-Crown Screw-Retained Implant-Supported Prostheses

PURPOSE: New solutions need to be developed for cases in which implants that were placed years ago are now presenting prosthetic complications. A conical head screw design for a single-tooth abutment was developed to preserve the initial applied torque. The aim of this study was to assess the preload maintenance of different screw design sets (a conical head screw set and a flat head screw set) for single-tooth abutments in external hexagon implants, verifying whether reverse torque changes after mechanical loading at different crown/implant ratios and to understand if the use of the tested conical head screw set design can help clinicians solve loosening torque. MATERIALS AND METHODS: Forty external hexagonal implants, 40 single-tooth abutments, 20 conical head screws, and 20 flat head screws were split into four groups with different crown/implant ratios (crown/implant ratio > 1 or crown/implant ratio .05) compared with the initial applied torque. For the flat head screw, the crown/implant ratio affected the torque maintenance. For the conical head screw, the crown/implant ratio did not affect the torque maintenance (P > .05). CONCLUSION: The conical head screw set presented a higher maintenance of applied preload than the flat head screw set. As far as reverse torque is concerned, the crown/implant ratio affects the torque maintenance only in association with a flat head screw set. The use of the tested conical head screw set can help clinicians solve loosening torque, mainly in a situation with a crown/implant ratio > 1.