Screw Coating as a Solution to Solve Screw Loosening Complications: An In Vitro Study

Background: This study aimed to evaluate the influence of a screw coating on the screw preload and removal torque value (RTV) with and without the application of a cyclic load (CL) to make screws with greater untightening resistance to prevent screw loosening. Methods: Ninety complexes composed of implants, abutments, and prosthetic screws were examined and tested under CL oral conditions (n = 45) and non-CL conditions (nCL, n = 45). Each group was divided into three subgroups (n = 15): a control group (CG) without a screw coating, a GapSeal^®-coated screw group (GG), and a polytetrafluoroethylene (PTFE) tape-wrapped screw group (PG). All screws were tightened at 30 Ncm, and the preload was recorded. In the nCL group, the screws were untightened to record the RTV. In the CL group, the screws were tightened, subjected to a CL in distillated water at a temperature of 37 °C, and then untightened to record the RTV. Micro-Ct analysis was conducted on two samples from each group before CL. SEM analyses of two samples per subgroup before and after CL were also performed. Results: The preload in the PG was significantly lower under nCL (29.92 Ncm) compared with CG (30.95 Ncm) and GG (31.19 Ncm) and also under a CL (PG: 30.92 Ncm) compared with CG (31.72 Ncm) and GG (31.42 Ncm). The RTVs of the PG were significantly lower under nCL (15.30 Ncm) compared with CG (27.98 Ncm) and GG (28.46 Ncm). Under CL, the RTVs of the PG were significantly higher (31.50 Ncm) compared with CG (26.00 Ncm) and GG (27.44 Ncm). Conclusions: Wrapping the screw with PTFE tape significantly reduced the preload but resulted in a significantly greater RTV under CL conditions in the simulated oral environment, suggesting that this could be a solution to decrease the risk of screw loosening.