Comparing Titanium and Gold-Coated Abutment Screws for Immediate Loading of Dental Implants in Partially Edentulous Patients. Four-year post-loading results from a randomised controlled trial

Aim To compare the clinical outcome of titanium versus gold-coated abutment screws for immediately loaded implants in partially edentulous patients. 

Materials and Methods One-hundred implants inserted with a torque superior to 25 Ncm in 59 partially edentulous patients were randomly allocated to receive titanium (49 implants) or gold-coated abutment screws (51 implants). Implants could be placed also as immediate post-extractive implants and were loaded immediately with single screw-retained crowns, replaced after 4 months by definitive ones. Outcome measures were crown and implant failures, and peri-implant marginal bone loss. 

Results At four years after loading 49 patients remained in the study with 77 implants rehabilitated with 39 titanium and 38 implants with gold-coated abutment screws. No implant or crown failed. Peri-implant mean marginal bone loss from implant placement was 0.67 ± 1.30 mm at titanium screws and 0.46 ± 1.62 mm at gold-coated screws with no statistically significant differences between the two screw types (mean difference = 0.21 mm, 95%CI -0.46 to 0.88, p = 0.53). 

Conclusions Within the limitations of this study, it can be concluded that the type of implant-abutment screw does not significantly affect peri-implant crestal bone. In addition, immediate implant placement and loading seems to be viable treatment alternatives.