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Hong, Bae, and Kim: The incidence of the abutment screw loosening and its affecting factors in posterior implant restorations
ORIGINAL ARTICLE

J Korean Acad Prosthodont 2018;56(3):212-217.

Published online: NaN July 2018

DOI: https://doi.org/10.4047/jkap.2018.56.3.212

The incidence of the abutment screw loosening and its affecting factors in posterior implant restorations

Su-Jung Hong, Jung-Yoon Bae∗, Hyun-Hee Kim

Department of Prosthodontics, Gil Medical Center, Gachon University, Incheon, Republic of Korea

∗Corresponding Author: Jung-Yoon Bae Department of Prosthodontics, Gil Medical Center, Gachon University 774-34, Namdong-daero, Namdong-gu, Incheon 21565, Republic of Korea +82 (0)32 460 3376: e-mail, bb1018@hanmail.net

Received 11 April 201825 May 2018       Accepted 7 June 2018

Copyright © 2018 The Korean Academy of Prosthodontics

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was to assess clinically the incidence of abutment screw loosening of posterior implant-supported fixed prosthesis and its affecting factors.

Materials and methods

391 implant-supported crowns restored from January 2013 to January 2016 were included in this study. All restorations were fabricated with either a single crowns or a splinted crown, and cemented with temporary cement. The incidence of abutment screw loosening is investigated and gender, restoration position, opposing teeth, restoration type, abutment connection type were assessed as possible factors affecting abutment screw loosening.

Results

During the observation period (2 - 5 years), abutment screw loosening was found in 29 restorations (7.4%). It took 3 to 48 months (means 19.5 months) to loose the screw, and three of these implants were fractured. Among the factors considered, there were statistically significant differences at abutment screw loosening rate between molar group (9.4%) and premolar group (2.6%) (P<.019). According to the type of opposing teeth, there were statistically significant differences between nature teeth (74.7%) and implant (25.0%), removable denture (3%) (P<.019). The other possible factors did not have a significant effect on loosening of the abutment.

Conclusion

The incidence of abutment screw loosening in posterior restoration was 7.4%. Abutment screw loosening were more likely to occur in molars group than premolar group, and according to the opposing teeth, there were the greatest frequency in nature teeth than implant and removal denture. There was a statistically significant difference. (J Korean Acad Prosthodont 2018;56:212-7)

Keywords: Screw loosening, Technical complication, Implant-supported dental prosthesis

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Table 1.
Distribution of implants with regard to implant position
  Upper premolar Upper molar Lower premolar Lower molar
Number of implants 69 114 46 162
Percentage of implants (%) 17.6 29.2 11.8 41.4
Table 2.
Occurrence of screw loosening in varia able factors
Factor   Status of screw loosening Total X2 (P)
Y (%) N
Position Premolar 3 (2.6) 112 115 5.485(.019∗)
Molar 26 (9.4) 250 276
Diameter of fixture ≤ 4.5 24 (7.7) 289 313 .114 (.705)
  > 4.5 5 (6.4) 73 78  
Opposing teeth Natural teeth 28 (9.9) 264 292 8.059 (.018∗)
Implant 1(1.0) 97 98
RPD   0 (0) 1 1
Restoration type Single crown 14 (9.6) 132 146
  Splinted crown 12 (5.6) 203 215
  Bridge 3 (10.0) 27 30
Connection type Internal hex 22 (6.9) 296 318
  Cornical 7 (9.6) 66 73

∗significantly different (P < .05); RPD: Removable Dental Prosthesis

Table 3.
Occurrence of screw loosening according to gender
Factor   Status of screw loosening Total X2 (P)
Y (%) N
Gender Male 12(11.3) 94 106 .723 (.395)
Female 8(7.8) 94 102

∗significantly different (P < .05)

Table 4.
The incidence of implant abutment classified by fixture diameter
Fixture diameter 3.5 4.0 4.5 5.0 5.5 6.0 Total X2 (P)
Total 12 115 163 65 4 3 391 2.029 (.845)
Number of screw loosening (%) 0 (0) 11 (9.6) 12 (7.4) 6 (9.2) 0 (0) 0 (0) 29
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