Background The sealing of implant screw access chambers can influence prosthesis success, peri‐implant health and patient comfort. The aim of this study was to compare the microleakage of single implant crown screw access chambers sealed with and without a composite resin adhesive. Methods Twenty milled lithium disilicate crowns were luted to titanium‐base abutments, attached to implants and randomly assigned to one of two groups. The first group had the screw access chamber sealed with polytetrafluoroethylene tape, a 10‐methacryloyloxydecyl dihydrogen phosphate containing adhesive, and composite resin. The second group used the same procedure but without an adhesive. All samples were sealed at the implant‐abutment interface and subjected to thermocycling then immersed in a ferrous sulphate contrast media for 48 h. Infiltration and microleakage was measured using a microcomputed tomography scanner. Results All samples demonstrated high resistance to microleakage with no significant contrast media diffusion in either of the two groups. Conclusions Within the limitations of this in vitro study, the use of a composite resin adhesive for sealing the screw access chamber for single implant crowns provided no additional sealing capacity compared with composite resin alone. Composite resin restorations placed in the traditional manner without sealing provided excellent resistance to microleakage.

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