In‐Vitro Study of the Contamination Remaining on Used Healing Abutments after Cleaning and Sterilizing in Dental Practice

Wadhwani, Chandur; Schonnenbaum, Todd R; Audia, Franco; Chung, Kwok‐Hung

doi:10.1111/cid.12385

Cited by 31 publications

(58 citation statements)

References 16 publications

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“…It is possible that this residue is bacteria based, which could explain the small areas of oxidative discoloration on the surface, as bacterial metabolites are known to induce oxidation on titanium surfaces . Additionally, the presence of biological debris even after the cleaning and sterilization performed in the study may provide rationale to re‐evaluate the common practice of re‐using healing abutments clinically, as the effects of these residual organic materials on peri‐implant tissues is not known …”

Section: Discussionsupporting

confidence: 76%

“…The detection of nitrogen, calcium, and phosphorus in addition to generally present carbon and oxygen results suggests that this residue is biological and not just the carbonaceous contamination found on all surfaces . Because a portion of the IHAs are exposed to the oral environment during placement, the source of this residue could be bacterial plaque, bolus, soft‐tissue, or a variety of protein based compounds present in saliva that have adhered to the surface . It is important to note that formation of bacterial biofilm starts with a conditioning layer adsorbed onto the titanium surface of glycoproteins, Ca 2+ , Mg 2+ , and water which early colonizers use to adhere to the surface of titanium.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Surface characterization of titanium implant healing abutments before and after placement

Wheelis

Wilson²,

Valderrama³

et al. 2017

Clin Implant Dent Rel Res

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Surface characterization of titanium implant healing abutments before and after placement

Wheelis

Wilson²,

Valderrama³

et al. 2017

Clin Implant Dent Rel Res

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“…It was also important to underline how the re-use of HAs among different patients, mainly for economic reasons, may have effects on the early inflammation of the peri-implant tissues linked to the residues present after the common sterilization cycles. In two different studies [45,46], authors studied the effect of re-use of HAs in clinical practices. Wadhwani et al [45] showed that the healing screws treated according to the standard cleaning and sterilization protocols for subsequent uses showed residues protein contamination at one or more sites in 90% of cases.…”

Section: Discussionmentioning

confidence: 99%

“…In two different studies [45,46], authors studied the effect of re-use of HAs in clinical practices. Wadhwani et al [45] showed that the healing screws treated according to the standard cleaning and sterilization protocols for subsequent uses showed residues protein contamination at one or more sites in 90% of cases. Also, Stacchi et al [46] demonstrated a better cell binding in HAs treated with specific cleaning methods compared with the control re-used screws and treated with standard methods.…”

Section: Discussionmentioning

confidence: 99%

Immunohistochemical Evaluation of Peri-Implant Soft Tissues around Machined and Direct Metal Laser Sintered (DMLS) Healing Abutments in Humans

Mangano

Shibli

et al. 2018

IJERPH

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Background: Direct metal laser Sintering (DMLS) is an additive manufacturing technique that allows fabrication of dental implants and related components with a highly porous surface. To date, no human studies have investigated the soft tissue adhesion and presence of inflammatory infiltrate with porous DMLS healing abutments (HAs), nor have they compared these with the classic machined ones. Purpose: To evaluate the degree of cell adhesion (integrin expression) and the quantity/quality of inflammatory infiltrate, on HAs with different surfaces; full DMLS, full machined, and hybrid (half DMLS and half machined). Methods: Fifty implant patients were randomly assigned to receive one of these different Has: T1, full DMLS (11 subjects); T2, machined in the upper portion and DMLS in the lower one (10 subjects); T3, DMLS in the upper portion and machined in the lower one (19 subjects); T4, full machined (10 patients). Thirty days after placement, circular sections of soft tissues around HAs were retrieved for immunohistochemical evaluation. Results: With regard to the adhesion molecules, the samples showed different intensity of integrin expression, with a statistically significant difference (p < 0.001) between T1 and the other groups. All the samples were positive for the different clusters related to the inflammatory infiltrate (T lymphocytes, CD3; B lymphocytes, CD20; and macrophages, CD68), but a lower infiltrate was found in T1, with statistically significant differences (p < 0.001) among the groups. Conclusions: The HA surface seems to influence the degree of cell adhesion and the inflammatory infiltrate of the surrounding soft tissues.

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“…In dentistry, there are several devices that are reused across patients encompassing all dental specialties, such as surgical instruments, burs, bone saws, endodontic files, periodontal instruments, orthodontic devices, x‐ray holders, and several instruments in pediatric dentistry. In implant dentistry, common examples of ad‐hoc reusable devices include surgical instruments, surgical handpieces, surgical drills, bone cutting burs, impression copings, and many more . Examples of in‐situ reusable devices in implant dentistry include healing abutments, cover screws, abutments, abutment screws, and prosthetic screws.…”

mentioning

confidence: 99%

Should Healing Abutments and Cover Screws for Dental Implants be Reused? A Systematic Review

Kejriwal

Bhuse

2019

Journal of Prosthodontics

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Purpose To systematically review the current scientific evidence to assess if healing abutments and cover screws for dental implants can be resterilized effectively for reuse. A secondary purpose was to investigate if there has been any reported adverse biological or mechanical consequences to implants, or harm to patients with the reuse of healing abutments or cover screws. Materials and Methods An electronic search of the English language scientific literature was performed independently by multiple investigators using a systematic search process using the PubMed search engine and Cochrane database. After the application of predetermined inclusion and exclusion criteria, the final list of articles was reviewed to meet the various objectives of this review. Results The initial electronic search resulted in 657 titles and after the application of predetermined inclusion and exclusion criteria, six articles were identified that satisfied the study objectives. All six articles were observational studies that described a total sample of over 300 used healed abutments obtained from patients. Out of these, three studies showed that routine methods (mechanical, chemical, and steam) used for cleaning and sterilizing used healing abutments did not result in the complete removal of contaminants, while two studies showed that routine methods supplemented with an additional regimen resulted in adequate decontamination. One additional study showed that routine methods sufficiently resulted in adequate decontamination of used healing abutments. There were no true clinical studies identified. There were no studies identified in the literature that reported on any adverse consequences to dental implants, such as infections, bone loss, mechanical complications, implant failure, or harm to patients, by reuse of healing abutments or cover screws. Conclusions Limited evidence suggests that routine methods used for cleaning and sterilization of used titanium healing abutments may not result in the complete removal of contaminants. However, the biological or mechanical implication of this finding is yet to be determined because presently there are no reports in the literature related to any unfavorable consequences to dental implants, or harm to patients by reuse of healing abutments or cover screws. Nevertheless, due to the popular clinical practice of reusing healing abutments to reduce cost to clinicians and patients, indiscriminate reuse of healing abutments should be avoided, until further supporting evidence is established.

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In‐Vitro Study of the Contamination Remaining on Used Healing Abutments after Cleaning and Sterilizing in Dental Practice

Abstract: Reuse of healing abutments between patients should be reevaluated in light of this data.

Cited by 31 publications

References 16 publications

Surface characterization of titanium implant healing abutments before and after placement

Surface characterization of titanium implant healing abutments before and after placement

Immunohistochemical Evaluation of Peri-Implant Soft Tissues around Machined and Direct Metal Laser Sintered (DMLS) Healing Abutments in Humans

Should Healing Abutments and Cover Screws for Dental Implants be Reused? A Systematic Review

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