Several authors still consider the mechanical problems of fracture and component loosening as the main causes of failure of implant-supported restorations. The purpose of this in vitro study was to compare the preload of three types of screw for transmucosal abutment attachment used in single implant-supported prosthesis through strain gauge and removal torque measurements. Three external hex fixtures were used, and each received a transmucosal abutment (Cera One®), which was fixed to the implant with its respective screw: Group A- gold screw, Group B- titanium screw and Group C- surface-treated titanium screw (Ti-Tite®). Ten screws of each type were attached applying a 30.07±0.28 Ncm torque force and maintained in position for 5 minutes. After this, the preload values were measured using strain gauges and a measurement cell. Gold screws presented higher preload values (131.72±8.98 N), followed by surface-treated titanium screws (97.78±4.68 N) and titanium screws (37.03±5.69 N). ANOVA (p<0.05) and Tukey's test (p<0.05) were applied. Statistically significant differences were found among the groups for both preload and removal torque values. In conclusion, gold screws may be indicated to achieve superior longevity of the abutment-implant connection and, consequently, prosthetic restoration due to greater preload values yielded.

The fast evolution of surface treatments for biomedical implants and the concern with their contact with cells and microorganisms at early phases of bone healing has boosted the development of surface topographies presenting drug delivery potential for, among other features, bacterial growth inhibition without impairing cell adhesion. A diverse set of metal ions and nanoparticles (NPs) present antibacterial properties of their own, which can be applied to improve the implant local response to contamination. Considering the promising combination of nanostructured surfaces with antibacterial materials, this critical review describes a variety of antibacterial effects attributed to specific metals, ions and their combinations. Also, it explains the TiO2 nanotubes (TNTs) surface creation, in which the possibility of aggregation of an active drug delivery system is applicable. Also, we discuss the pertinent literature related to the state of the art of drug incorporation of NPs with antibacterial properties inside TNTs, along with the promising future perspectives of in situ drug delivery systems aggregated to biomedical implants.