Well he’s got a screw loose: Loose abutment and the ID Multi Torque Wrench

If you do enough implant crowns this will happen to me.  It also surprises me how much of a moron I was when I first started restoring implants.  If an abutment screw loosened up I would cut off the whole crown and abutment and start al over.  Most of the restorations I do now are screw retained and not PFM but if one happens to loosen up, just “convert” the abutment and crown into a screw retained crown.  We cement tibases to ceramic frameworks all the time. If the abutment depends from the crown then you can start over.  First I look at the radiograph to determine where under the crown the implant is.  Then I go with a diamond cylinder bur then a carbide 330 till I reach some stinky cotton or teflon tape.  Hola!  Screw retained crown!

If a screw loosens I usually replace it with a new abutment screw.  I love the Implant Direct Multi Torque wrench as you can simply dial in the amount of torque you need.  Placed lots of teflon tape, opaque flowable and paste composite using my protocol found elsewhere on Digital Enamel! After adjusting the occlusion it was obvious that his bite was what loosened it up!