Factors Influencing the Screw Stability of Implant-Supported Single Crowns: An In Vitro Study

The aim is to investigate the impact of retention type, implant/abutment angulation, and the presence of sealant/antimicrobial agents on screw loosening of implant-supported restorations. Fifty dental implants along with their respective abutments and screws were allocated to five groups (n = 10). The groups were categorized based on type of crown retention (screw-/cement-retained), implant/abutment angulation (0°/20°), and type of disinfectant/sealant as follows: Cem_control (cemented/0°/none), Cem_GP (cemented/0°/gutta-percha), Cem_CHX (cemented/0°/chlorhexidine), Cem_Ang (cemented/20°/none), and Screw (screwed/0°/ none). Abutment screws were tightened (20 Ncm), and CAD/CAM zirconia crowns were fabricated. Glass ionomer cement was used for crown cementation in the cemented groups. Samples were subjected to dynamic loading in a chewing simulator (1,200,000 cycles/98 N). After loading, the reverse torque values (RTVs) of the abutment screws were determined (Ncm) using an electronic screwdriver, and the reverse torque difference (RTD) was subsequently calculated. The lowest RTD was reported in group Cem_GP (-2.22 ± 1.03), whereas the highest RTD was seen in group Screw (-4.65 ± 1.79). Group Screw showed a statistically significant difference from all other groups (p < 0.05). No statistically significant difference between the cemented test groups Cem_GP, Cem_CHX, and Cem_Ang and the control group was found. Screw-retained restorations exhibited significantly greater RTD values compared to cement-retained ones. Implant/abutment angulation and the sealant/disinfectant appeared to have no notable effect on the screw stability of single-implant restorations.