Diamond-Like Carbon Coating Reduces Connection Screw Head Stripping After Multiple Tightening Instances

: The stability of implant-abutment joint is fundamental for the long-term success of implant rehabilitation. The screw loosening, fracture, and head deformation are among the most common mechanical complications. Several surface treatments of titanium screws have been proposed to improve their resistance and stability. Diamond-like carbon (DLC) coating of the materials is widely used to increase their wear resistance and durability. The present study aimed to evaluate the effect of carbon fiber coating on the screw head on screw removal torque and screw head stripping. One hundred titanium implant screws were used, 50 without coating (Group 1) and 50 with DLC coating of the screw head (Group 2). Each screw was tightened with a torque of 25 Ncm and unscrewed 10 times. The removal torque was measured with a digital cap torque tester for each loosening. Optical 3d measurement of the screw head surface was performed by a fully automatic machine before and after multiple tightening to investigate surface modifications. The reverse torque values decreased with repeated tightening and loosening cycles in both groups without significant differences (P > .05). Optical measurements of surface dimensions revealed average changes of 0.0357 mm in Group 1 and 0.02312 mm in Group 2, which resulted to be statistically significant (P < .001). The DLC coating of the retention screw head can prevent its distortion and wear, especially after multiple tightening.