Preload loss of abutment screws after dynamic fatigue in single implant-supported restorations. A systematic review

BACKGROUND: To carry out a systematic literature review of the causes of preload loss of the abutment screws, of internal and external connection implants, tightened to different torque values and subjected to cyclic loading. MATERIAL AND METHODS: A systematic search was conducted in PubMed, EMBASE, and Cochrane Library databases with reference to in vitro studies in which internal and external connection implants were subjected to cyclic loads to determine the degree of loosening of the abutment screws after loading. RESULTS: The reviewed studies tested distinct implant connections (mostly externally hexed, and morse taper) subjected to diverse cycles (from 16667 to 1 million), with loads ranging from 0-400 Nw, using screws of different materials and designs that were tightened into torques between 20-45 Ncm, Accordingly after loading the percentage of torque loss ranges between 16.1% to 39%. CONCLUSIONS: Most of the studies indicate that the internal connection, together with the morse taper, best resists cyclic loading in terms of screw loosening in single-tooth implants. Key words:Dental Implants, Dental Implant-Abutment Design, Torque, In Vitro Techniques, Systematic Review.