Contemporary Sterilization Protocols of Healing Abutments for Reusability: A Systematic Review

Abstract

Introduction: Although healing abutments are designated for single use by most implant manufacturers, it is common practice for clinicians to reuse healing abutments. However, there is a lack of adequate references that describe detailed sterilization protocols for reuse of healing abutments. Objectives: The purpose of this systematic review was to compile, organize, and describe the most common techniques for the sterilization of healing abutments and their efficiency in eliminating traces of microorganisms. Methods: An electronic search in 5 different databases was performed, including the National Library of Medicine (MEDLINE via PubMed), Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar from January 2000 to December 2020. Search variables included were dental implant, healing abutment, contaminate, contamination, reuse, and sterilization. Studies reporting with a minimum sample size of 10 healing abutments (5 per group) published in the English language were evaluated. Risk of bias assessment was elaborated for included investigations. Results: In total, 812 articles were identified, of which 8 were included in the analysis. Steam autoclave was the most widely used form of resterilization. Not a single protocol, however, was able to achieve 100% virgin surface of the healing abutments. Conclusion: Although reuse of dental implant healing abutments is a cost-effective measure in dental practice, thorough surface decontamination followed by resterilization is highly recommended before reuse. Knowledge Transfer Statement: With consideration of cost and patient preference, results of this review would be useful in knowing various sterilization protocols for reusing healing abutments that could lead to more appropriate therapeutic decisions.

Reuse of healing abutments: Ethical, biological and professional training implications

“…All professionals use autoclave as a sterilization method. However, with the permanence time of these components in contact with organic matter and oral fluids ranging from 30 to 180 days and, still, with the reuse being performed repeatedly (91.8%), a compact biofilm colonized by a viable microbiota can form and strongly adhere to the component ( 10 ), and therefore, cannot be completely removed by the methods described ( 16 - 18 ).…”

“…Several studies show that there is a high possibility of contamination of healing abutments even after cleaning procedures ( 4 , 8 - 10 , 14 , 16 , 19 ). As elucidated in the present study, professionals involved in treatment with dental implants reuse healing abutments and have minimal perception of the risks.…”

Could Dental Material Reuse Play a Significant Role in Preservation of Raw Materials, Water, Energy, and Costs? Microbiological Analysis of New versus Reused Healing Abutments: An In Vitro Study

“…1. Decontamination [28][29][30]; HAs are soaked for 15 min in decontamination baths containing 2 g of powdered disinfectant solution diluted in 1 liter of warm water. Com-…”

“…The packaging included traceability data for the sterilization cycle, such as the sterilization operator's signature, the autoclave-indicated sterilization cycle number, packaging date, and expiration date (set at 30 days from packaging). The packages must feature an external chemical indicator of class 1 (UNI EN ISO 11140-1), which indicates whether the package has undergone processing (process indicator) [30]; 6.…”

Effect of autoclaving on implant abutments from genesis and bredent dental implant systems

“…Repeated adjustments and the use of abutments require repeated sterilization. During the sterilization of abutments, multiple autoclave cycles might cause changes in the surface and other mechanical properties [ 9 ]. Sterilization has proven to reduce the biological microbial load from the abutment and implant surface, but the mechanical changes associated with these procedures are yet to be studied.…”