The purpose of this study was to determine whether varying the preload on the implant-abutment complex would affect screw loosening under simulated loading conditions. Abutment screws in sample models were tightened to 25, 30, 35, and 40 N-cm. One group of samples was allowed to stand for 3 hours after being torqued and then loosened. Another group of samples was retorqued after 10 minutes with the same initial torque value and then allowed to stand for 3 hours before loosening. For the load group of samples, the abutments were torqued into place, retorqued after 10 minutes, and a load applied for 3 hours before loosening. Cyclic loading was carried out using a servo-hydraulic testing machine with the values cycled between 1 and 26 pounds and the load applied directly to the abutments. Analysis of variance, analysis of covariance, and linear regression analysis was performed. Within the parameters of this in vitro investigation, the following recommendations can be made: (1) retightening abutment screws 10 minutes after the initial torque applications should be routinely performed and (2) increasing the torque value for abutment screws above 30 N-cm can be beneficial for abutment-implant stability and to decrease screw loosening.

Type 2 diabetic patients tend to have more failures than non-diabetic patients; however, the influence was marginally significant. These findings need to be confirmed by other scientific clinical studies with a larger Type 2 diabetic sample size.

One of the most serious and prevalent problems associated with the restorative aspect of dental implants is loosening and fracturing of screws. Implant screws should be retightened 10 minutes after the initial torque application as a routine clinical procedure to help compensate for the settling effect. Mechanical torque gauges should be used instead of hand drivers to ensure consistent tightening of implant components to torque values recommended by implant manufacturers.

The results indicate that: 1) shorter implants had statistically lower survival rates as compared with longer implants; 2) 3+ mm diameter implants had a lower survival rate as compared with 4+ mm implants; 3) 3+ mm diameter implants are less stable (more positive PTVs) than 4+ mm implants; and 4) there was no significant difference in crestal bone loss for the two different implant diameters between placement and uncovering.

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