This in vitro experiment aimed to understand the difference in preload acting on an abutment screw under different angles of angulated screw-retained crown and the performance after cyclic loading. In total, thirty implants with angulated screw channel (ASC) abutments were divided into two parts. The first part consisted of three groups: a 0° access channel with a zirconia crown (ASC-0) (n = 5), a 15° access channel with a specially designed zirconia crown (sASC-15) (n = 5), and a 25° access channel with a specially designed zirconia crown (sASC-25) (n = 5). The reverse torque value (RTV) was measured at 0° for each specimen. The second part consisted of three groups: a 0° access channel with a zirconia crown (ASC-0) (n = 5); a 15° access channel with a zirconia crown (ASC-15) (n = 5), and a 25° access channel with a zirconia crown (ASC-25) (n = 5). The manufacturer's recommended torque was applied to each specimen, and baseline RTV was measured before cyclic loading. Each ASC implant assembly was cyclically loaded at 0 to 40 N with 1 million cycles at 10 Hz. RTV was measured after cyclic loading. Kruskal-Wallis test and Jonckheere-Terpstra test were used for statistical analysis. All specimens were examined under a digital microscope and scanning electron microscope (SEM) to observe the wear of the screw head before and after the whole experiment. A significant difference in the different percentages of straight RTV (sRTV) between the three groups was found (p = 0.027). The angle of ASC to the different percentages of sRTV showed a significant linear trend (p = 0.003). No significant differences were found in RTV difference after cyclic loading among the ASC-0, ASC-15, and ASC-25 groups (p = 0.212). The ASC-25 group had the most serious degree of wear based on a digital microscope and SEM examination. The ASC angle will affect the actual preload acting on a screw: the larger the ASC angle, the smaller the preload. The performance of the angled ASC groups in RTV difference was comparable to that of 0° ASC after cyclic loading.
Keywords: angulated screw channel; angulated screw-retained crown; cyclic loading; implant; mechanical stresses; reverse torque value.