Dental implant restoration has been widely accepted as one of the treatment modalities to replace missing teeth and to restore human masticatory function. The use of root form endosseous implant has increased considerably and this restorative option has become more refined with the introduction of newer designs and concepts. Long term post placement studies have reported prosthetic complications, including screw loosening, screw fracture, framework and implant fracture. Abutment screw loosening is the second most common cause of failure of implant supported restoration, next to loss of osseointegration. This is more seen in single implant supported restoration. Management of screw loosening is challenging and this clinical report describes the management of an implant abutment screw loosening of upper anterior teeth with minimal damage to the existing restoration making it possible to be reused and a literature review on the various factors associated with abutment screw loosening.
Keywords: Abutment screw loosening; External and internal hex connection; Preload; Settling effect.