Implant abutment screw loosening and management: A narrative review.

Abstract Objective: To provide knowledge and to understand the causes, clinical impact and management of implant abutment screw loosening. Background: Implant-supported prostheses are a cornerstone of restorative dentistry due to their high success rates and functional outcomes. Abutment screw loosening, a common mechanical complication remains a challenge, particularly in posterior single-implant restorations and systems with external connections. Methodology: An electronic search of various published articles were collected from PubMed and Google Scholar and reviewed systematically between 1995 and 2025 years. Discussion: Abutment screw loosening is influenced by preload loss, connection design, material properties, and occlusal forces. Various studies have highlighted the importance of optimized torque, coated screws, and sealing agents. Internal and conical connections offer superior stability, reducing micromovements and enhancing long-term implant success. Conclusion: Despite advancements, abutment screw loosening remains a clinical concern. Literature highlights the need for standardized protocols and long-term studies to improve prevention, emphasizing the importance of focused research and clearer clinical guidelines.