Management of Dental Implant Components Following Abutment Screw Loosening: A Case Report
Management of implant abutment screw loosening should go beyond simply retightening the abutment screw. This case report highlights the need to check all components for damage before disinfection and re-tightening if possible. Major concerns include the implant-abutment connection site, screw, and debridement of the internal implant surfaces. Scanning electron microscopy and optical microscopic exam of the debris removed after cleaning demonstrated the presence of titanium metal particles and biological materials. Protocols should be developed to address these issues before reattaching the implant restoration.
(a) Loose implant molar crown: Buccal aspect. (b) Corresponding radiograph.
(a) Silicone micro brush original ×10 magnification. (b) Paper point at ×10 original magnification. (c) Paper point. (d) Paper point ×40 original magnification.
Contaminated abutment screw 10× magnification.
(a) Gridded filter paper Debris, 8× original magnification. (b) Gridded filter paper Debris, 40× original magnification with biological (brown colored). Nonbiological material (black). Note: Grid line width is approximately 50 µm.
(a) Representative images on filter paper. Distinct dark shapes considered metal particles were noted at the original magnification. (b) Representative images on filter paper. Biological 80× material identified from shape and color.
Scanning electron microgram of representative debris with electron dispersion spectrum.
Contributor Notes