Practical clinical guidelines to prevent screw loosening

The use of a screw-retained prosthesis on an osseointegrated implant is a popular treatment modality offering relative case in the removal of the restoration. One of the complications associated with this modality is the loosening of the abutment and coping screws. Loosening of the screws results in patient dissatisfaction, frustration to the dentist and, if left untreated, component fracture. There are several factors which contribute to the loosening of implant components which can be controlled by the restorative dentist and the lab technician. This article addresses the contributory factors and offers solutions which can be easily incorporated in the treatment.