Reuse of Healing Abutment- A Controversy

LOOQZ ePOSTER CLINICAL RESEARCH – PROSTHETICS

Background: Manufacturers recommend new healing abutments for each patient to prevent peri-implantitis. However, reuse of these components are considered because of financial constraints. Lack of adherence to proper cleaning and sterilization techniques of these reused components may result in transmission of blood and tissue borne pathogens among patients. However, recent studies have confirmed that sterilization of these components increased soft tissue adhesion on these components.

Aim/Hypothesis: The aim of the present study is to compare different sterilization methods for the reuse of implant healing abutments.

Materials and Methods: Forty eight titanium healing abutments were collected and artificially contaminated with Aggregatibacter actinomycetemcomitans(Aac), Prevotella intermedia(Pi) and Porphyromonas gingivalis(Pg) microorganisms. They were divided into 3 groups (n = 16) and sterilized with steam autoclave, ethylene oxide and low temperature gas plasma sterilization methods. Microbial analysis of all the decontaminated healing abutments was done. The resultant values were tabulated for all the specimens in each subgroup and subjected to statistical analysis to draw the conclusion from resultant data.

Results: Descriptive statistical measures such as mean and Standard deviations are computed for all groups and statistical significance between the groups was calculated using 2 way ANOVA (P < 0.005) and correlation between the groups was studied using Newman - Keuls multiple post hoc test (P < 0.005). Results showed less microbial adhesion and surface degradation of healing abutments which were sterilized by low temperature gas plasma followed by ethylene oxide sterilization.

Conclusions and Clinical Implications: This study concluded that if proper sterilization methods used, the healing abutments can be reused for cost containment for both clinician and patient. In case of immediate abutment connection, cleaning of the prosthetic components could benefit peri-implant crestal bone and soft tissue maintenance. In addition, plasma of argon could be used as a good method to disinfect implant abutments prior to its insertion to minimize future peri-implant bone resorption.

Keywords: healing abutment reuse, sterilization, low temperature gas plasma, ethylene oxide