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.