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Burioni R, Silvestrini L, D’Orto B, Tetè G, Nagni M, Polizzi E, Gherlone EF. 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. Bioengineering (Basel) 2024; 11:387. [PMID: 38671808 PMCID: PMC11048622 DOI: 10.3390/bioengineering11040387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/09/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
AIM The objective of this in vitro study was to compare reused and sterilized versus new healing abutments to assess whether a decontamination and sterilization process performed on resued healing abutments was sufficient to remove residual proteins. The two groups were comparable with respect to patient safety. MATERIALS AND METHODS During the period from September 2022 to October 2023, healing abutment screws were selected and divided into two groups according to whether they were new or previously used in patients. The samples were subjected to a decontamination and sterilization protocol, and results from sample sterility evaluation and assessment of surface protein levels were recorded. RESULTS The obtained results revealed a significant difference in the OD562 nm values between new and reused healing abutment samples. The assay demonstrates how treated healing abutments were still contaminated by residual proteins. CONCLUSION Within the limitations of the present study, although from an infectious point of view sterilization results in the total eradication of pathogens, surface proteins remain on reused healing abutments.
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Affiliation(s)
- Roberto Burioni
- Department of Microbiology and Virology, University “Vita-Salute” San Raffaele, 20132 Milan, Italy; (R.B.); (L.S.)
| | - Lucia Silvestrini
- Department of Microbiology and Virology, University “Vita-Salute” San Raffaele, 20132 Milan, Italy; (R.B.); (L.S.)
| | - Bianca D’Orto
- Department of Dentistry, Dental School, IRCCS San Raffaele Hospital, “Vita-Salute” San Raffaele University, 20132 Milan, Italy; (B.D.); (G.T.); (M.N.)
| | - Giulia Tetè
- Department of Dentistry, Dental School, IRCCS San Raffaele Hospital, “Vita-Salute” San Raffaele University, 20132 Milan, Italy; (B.D.); (G.T.); (M.N.)
| | - Matteo Nagni
- Department of Dentistry, Dental School, IRCCS San Raffaele Hospital, “Vita-Salute” San Raffaele University, 20132 Milan, Italy; (B.D.); (G.T.); (M.N.)
| | - Elisabetta Polizzi
- Chair Center for Oral Hygiene and Prevention, Department of Dentistry, Dental School, IRCCS San Raffaele Hospital, “Vita-Salute” San Raffaele University, 20132 Milan, Italy
| | - Enrico Felice Gherlone
- Dental School, IRCCS San Raffaele Hospital, “Vita-Salute” University, 20132 Milan, Italy;
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Canullo L, Donato A, Savadori P, Radovanovic S, Iacono R, Rakic M. Effect of argon plasma abutment activation on soft tissue healing: RCT with histological assessment. Clin Implant Dent Relat Res 2024; 26:226-236. [PMID: 37853303 DOI: 10.1111/cid.13286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 09/27/2023] [Accepted: 09/30/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE To assess the peri-implant soft tissue profiles between argon plasma treatment (PT) and non-treated (NPT) healing abutments by comparing clinical and histological parameters 2 months following abutment placement. MATERIALS AND METHODS Thirty participants were randomly assigned to argon-plasma treatment abutments group (PT) or non-treated abutments (NPT) group. Two months after healing abutment placement, soft peri-implant tissues and abutment were harvested, and histological and clinical parameters including plaque index, bleeding on probing, and keratinized mucosa diameter (KM) were assessed. Specialized stainings (hematoxylin-eosin and picrocirious red) coupled with immunohistochemistry (vimentin, collagen, and CK10) were performed to assess soft tissue inflammation and healing, and the collagen content keratinization. In addition to standard statistical methods, machine learning algorithms were applied for advanced soft tissue profiling between the test and control groups. RESULTS PT group showed lower plaque accumulation and inflammation grade (6.71% vs. 13.25%, respectively; p-value 0.02), and more advanced connective tissue healing and integration compared to NPT (31.77% vs. 23.3%, respectively; p = 0.009). In the control group, more expressed keratinization was found compared to the PT group, showing significantly higher CK10 (>47.5%). No differences in KM were found between the groups. SIGNIFICANCE PT seems to be a promising protocol for guided peri-implant soft tissue morphogenesis reducing plaque accumulation and inflammation, and stimulating collagen and soft tissue but without effects on epithelial tissues and keratinization.
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Affiliation(s)
- Luigi Canullo
- Department of Surgical Sciences (DISC), University of Genoa, Genova, Italy
- Department of Periodontology, University of Bern, Bern, Switzerland
| | | | - Paolo Savadori
- Department of Biomedical, Surgical and Dental Sciences, Università Degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Maxillo-Facial Surgery and Dental Unit, Milan, Italy
| | - Sandro Radovanovic
- Faculty of Organizational Sciences, University of Belgrade, Belgrade, Serbia
| | - Roberta Iacono
- Department of Oral and Maxillo-facial Sciences, Sapienza University of Rome, Rome, Italy
| | - Mia Rakic
- Facultad de Odontologia, Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, Universidad Complutense de Madrid, Madrid, Spain
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Ila Rajendra P, Abhijeet RK, Pronob Kumar S. Effect of repeated autoclaving on implant abutments from genesis and bredent dental implant systems. Bioinformation 2023; 19:1419-1425. [PMID: 38415044 PMCID: PMC10895519 DOI: 10.6026/973206300191419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 12/31/2023] [Accepted: 12/31/2023] [Indexed: 02/29/2024] Open
Abstract
The effect of repeated autoclaving on the implant-abutment connection of titanium abutments from Genesis and Bredent dental implant systems is of interest to dentists. 40 screw-retained titanium implant abutments from Genesis and Bredent were divided into four groups of ten. Each implant was secured with an abutment using screws. Abutments were prepared for the first 30-minute autoclave cycle at 121°C. After the first autoclave cycle, the abutments were fitted onto their implant systems and examined under a scanning electron microscope (SEM). Intra-group comparison between marginal gaps of Genesis and Bredent groups at 1st autoclave and 2nd autoclave observed statistically significant differences respectively (p<0.05). Genesis group showed highest mean values for buccal and mesial sides (2.7) and lingual and distal sides (2.8) with statistically significant differences. Marginal gap and surface roughness increased with autoclaving for both Genesis and Bredent group of implant abutment systems.
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Affiliation(s)
- Patel Ila Rajendra
- Department of Prosthodontics and Crown and Bridge, School of Dental Sciences, Krishna Institute of Medical Sciences (KIMS-DU), Karad, Maharashtra, India
| | - Ramchandra Kore Abhijeet
- Department of Prosthodontics and Crown and Bridge, School of Dental Sciences, Krishna Institute of Medical Sciences (KIMS-DU), Karad, Maharashtra, India
| | - Sanyal Pronob Kumar
- Department of Prosthodontics and Crown and Bridge, School of Dental Sciences, Krishna Institute of Medical Sciences (KIMS-DU), Karad, Maharashtra, India
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Kyaw TT, Abdou A, Arunjaroensuk S, Nakata H, Kanazawa M, Pimkhaokham A. Effect of chemical and electrochemical decontamination protocols on single and multiple-used healing abutments: A comparative analysis of contact surface area, micro-gap, micro-leakage, and surface topography. Clin Implant Dent Relat Res 2023; 25:1207-1215. [PMID: 37654160 DOI: 10.1111/cid.13269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/21/2023] [Accepted: 08/15/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION Although the combined use of chemical and electrochemical decontamination protocols can completely remove contaminants from the surfaces of one-time used healing abutments (HAs), their effectiveness in multiple-used HAs remains unknown. We aimed to investigate the effect of reused HAs frequency on the implant-HA contact surface area, micro-gap, microleakage, and surface topography following chemical and combined chemical and electrochemical decontamination protocols. METHODS Ninety bone level titanium implants were assembled with 90 bone level HAs, in which 80 contaminated HA samples were collected from human participants. The retrieved HAs were randomly divided into two groups according to the cleaning protocol: ultrasonication with 5.25% NaOCl solution for 15 min and steam autoclaving (group I); ultrasonication with 5.25% NaOCl solution for 15 min, followed by electrochemical cleaning and steam autoclaving (group II). The control group (group III) comprised 10 new unused HAs. The cleaning protocol was applied after each insertion as follows: (a) single-use and cleaning, (b) double-use and double cleaning cycles, (c) triple-use and triple cleaning cycles, and (d) more than triple-use and more than triple cleaning cycles. The contact surface area and micro-gap were assessed with micro-computed tomography scanning technique, microleakage test using 2% methylene blue staining, surface morphology with scanning electron microscopy, and surface elemental composition with energy-dispersive X-ray spectroscopy analysis. RESULTS Group Id exhibited the smallest contact surface area. The values of the micro-gap volumes and microleakage were significantly different (p < 0.001) in the descending order of Id > Ic > Ib > IId > Ia, IIa, and III. Morphological evaluation of Groups IIa, IIb, and IIc revealed that residual biological debris was optimally removed without altering their surface properties. CONCLUSIONS Chemical and electrochemical decontamination protocols are more effective than NaOCl cleaning methods, particularly for multiple consecutive uses with better decontamination levels, which decreases micro-gap volume and microleakage without surface alterations. Although the use of combined decontamination protocols for the contact surface area at the implant-HA interface showed comparable results with the control, change in the contact surface area was observed following the NaOCl cleaning methods. Therefore, titanium HA reuse can be considered in multiple times, if they are cleaned and sterilized using combined chemical and electrochemical decontamination protocols.
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Affiliation(s)
- Thiha Tin Kyaw
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Ahmed Abdou
- Prosthodontic Dentistry Department, Division of Biomaterials, Faculty of Dentistry, King Salman International University, South Sinai, Egypt
| | - Sirida Arunjaroensuk
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Hidemi Nakata
- Department of Regenerative & Reconstructive Dental Medicine, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Manabu Kanazawa
- Department of Digital Dentistry, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Atiphan Pimkhaokham
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Canullo L, Rakic M, Corvino E, Burton M, Krumbeck JA, Chittoor Prem A, Ravidà A, Ignjatović N, Sculean A, Menini M, Pesce P. Effect of argon plasma pre-treatment of healing abutments on peri-implant microbiome and soft tissue integration: a proof-of-concept randomized study. BMC Oral Health 2023; 23:27. [PMID: 36650477 PMCID: PMC9843976 DOI: 10.1186/s12903-023-02729-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/10/2023] [Indexed: 01/18/2023] Open
Abstract
PURPOSE Biofilm-free implant surface is ultimate prerequisite for successful soft and bone tissue integration. Objective of the study was to estimate the effects of argon plasma healing abutment pre-treatment (PT) on peri-implant soft-tissue phenotype (PiSP), inflammation, plaque accumulation and the microbiome (PiM) between non-treated (NPT) and treated (PT) abutments following 3-months healing period. The hypothesis was that cell-conductive and antimicrobial properties of PT would yield optimal conditions for soft tissue integration. MATERIAL AND METHODS Two months following second-phase surgery, microbiological and clinical parameters were assessed around thirty-six healing abutments with two types of microtopography, smooth surface (MACHINED) and ultrathin threaded microsurface (ROUGH). A two level randomization schema was used to achieve equal distribution and abutments were randomly divided into rough and machined groups, and then divided into PT and NPT groups. PiM was assessed using next-generation DNA sequencing. RESULTS PiM bacterial composition was highly diverse already two months post-implantation, consisting of key-stone pathogens, early and late colonizers, while the mycobiome was less diverse. PT was associated with lower plaque accumulation and inflammation without significant impact on PiSP, while in NPT clinical parameters were increased and associated with periopathogens. NPT mostly harbored late colonizers, while PT exerted higher abundance of early colonizers suggesting less advanced plaque formation. Interaction analysis in PT demonstrated S. mitis co-occurrence with pro-healthy Rothia dentocariosa and co-exclusion with Parvimonas micra, Porphyromonas endodontalis and Prevotella oris. PiSP parameters were generally similar between the groups, but significant association between PiM and keratinized mucosa width was observed in both groups, with remarkably more expressed diversity in NPT compared to PT. PT resulted in significantly lower BOP and PI around rough and machined abutments, respectively, without specific effect on PiM and PiSP. CONCLUSIONS PT contributed to significantly the less advanced biofilm accumulation and inflammation without specific effects on PiSP.
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Affiliation(s)
- Luigi Canullo
- grid.5734.50000 0001 0726 5157Department of Periodontology, University of Bern, Bern, Switzerland ,grid.5606.50000 0001 2151 3065Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | - Mia Rakic
- grid.4795.f0000 0001 2157 7667ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Emilio Corvino
- grid.8404.80000 0004 1757 2304University of Florence, Florence, Italy
| | - Maria Burton
- Zymo Research Corporation, 17062 Murphy Ave, Irvine, CA 92614 USA
| | - Janina A. Krumbeck
- Zymo Research Corporation, 17062 Murphy Ave, Irvine, CA 92614 USA ,Pangea Laboratory, 14762 Bentley Cir., Tustin, CA 92780 USA
| | | | | | - Nenad Ignjatović
- grid.419857.60000 0001 2221 9722Institute of Technical Science of the Serbian Academy of Sciences and Arts, 11000 Belgrade, Serbia
| | - Anton Sculean
- grid.5734.50000 0001 0726 5157Department of Periodontology, University of Bern, Bern, Switzerland
| | - Maria Menini
- grid.5606.50000 0001 2151 3065Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | - Paolo Pesce
- grid.5606.50000 0001 2151 3065Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
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Paganotto G, Zimmer R, Klein-Junior CA, Rivaldo EG. Reuse of healing abutments: Ethical, biological and professional training implications. J Clin Exp Dent 2022; 14:e822-e826. [PMID: 36320674 PMCID: PMC9617269 DOI: 10.4317/jced.59831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 08/24/2022] [Indexed: 11/07/2022] Open
Abstract
Background The aim was to estimate the prevalence of reuse of healing abutments, the methods used in disinfection and to analyze the reasons that lead to the reuse of these components by professionals who work in rehabilitation with dental implants.
Material and Methods For this, an online data collection was carried out through a questionnaire developed in Google Forms. This questionnaire was applied to 284 specialists in implantology, randomized, of the 1,147 registered in the Regional Council of Dentistry of Rio Grande do Sul. The questionnaire was divided into three parts: the first containing the Free and Informed Consent Form; the second referring to the correspondents’ demographic data; and the third part with information on reuse, disinfection and sterilization routines used, risk perception and information from manufacturers. To estimate the prevalence in the reuse of healing abutments by implantologists, the frequency of responses was used.
Results The results showed that almost all implantologists reuse healing abutments (98.1%). The main reasons for reuse were cost (71.2%) and practicality (26%). Regarding the limitations, 53.3% do not see limitations in its reuse, 20% associate it with increased roughness, 17.8% with the accumulation of organic matter and 8.9% with cross-infection as limitations for reuse. Already 95.3% did not receive any guidance from manufacturers on the reuse of these components. Enzymatic detergent and ultrasonic bath was the most used cleaning method (50.7%) followed by ultrasonic bath (23.3%). Autoclave was the method used for sterilization for all respondents.
Conclusions The reuse of healing abutments is a practice adopted by implantologists in the state of Rio Grande do Sul, Brazil and most professionals do not observe limitations in this practice since these components are used repeatedly. Decontamination with enzymatic detergent and an ultrasonic bath is the most commonly used procedure associated with autoclave sterilization. Key words:Abutment, reuse, decontamination, sterilization.
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Affiliation(s)
- Gustavo Paganotto
- Postgraduate Program in Dentistry, Lutheran University of Brazil (ULBRA), Canoas, Brazil
| | - Roberto Zimmer
- Postgraduate Program in Dentistry, Lutheran University of Brazil (ULBRA), Canoas, Brazil
| | | | - Elken-Gomes Rivaldo
- Postgraduate Program in Dentistry, Lutheran University of Brazil (ULBRA), Canoas, Brazil
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Fernandes PF, Grenho L, Fernandes MH, Sampaio-Fernandes JC, Gomes PS. Microgap and bacterial microleakage during the osseointegration period: An in vitro assessment of the cover screw and healing abutment in a platform-switched implant system. J Prosthet Dent 2021:S0022-3913(21)00501-1. [PMID: 34711406 DOI: 10.1016/j.prosdent.2021.07.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/27/2021] [Accepted: 07/27/2021] [Indexed: 11/25/2022]
Abstract
STATEMENT OF PROBLEM Microgap and bacterial microleakage at the implant-prosthetic abutment interface are recognized concerns for implant-supported restorations, leading to inflammation of the peri-implant tissues, with deleterious consequences for crestal bone levels. However, little is known regarding the interface established between the implant and the healing abutment or cover screw placed for the osseointegration phase. PURPOSE The purpose of this in vitro study was to characterize the implant-cover screw and implant-healing abutment interfaces of a platform-switched implant system to determine the microgap and bacterial microleakage of the system and evaluate the biological response and functionality of an interface sealing agent. MATERIAL AND METHODS The interfacial microgaps of the implant-healing abutment and implant-cover screw interfaces were characterized by scanning electron microscopy (n=10), and bacterial microleakage was evaluated after colonization with Enterococcus faecalis in a 30-day follow-up (n=10). The sealing efficacy and irritation potential of a silicone-based sealer were determined by using the hen's egg test on chorioallantoic membrane assay. The 2-sample t test was performed to compare means between groups, and data presented with the Kaplan-Meier method were compared statistically by using the log-rank test (α=.05). RESULTS The interfacial microgap was less than 2.5 μm for both systems. Bacterial microleakage was noted in approximately 50% of the specimens, particularly at early time points, at both the healing abutment and cover screw interfaces. The silicone-based sealer prevented bacterial leakage in the experimental setting. CONCLUSIONS The implant-healing abutment and implant-cover screw interfaces of the tested system, despite the low microgap, allowed for bacterial microleakage after internal colonization. The use of a nonirritating silicone-based sealing agent effectively sealed the system.
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Affiliation(s)
- Pedro F Fernandes
- Graduate student, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Liliana Grenho
- Invited Assistant Professor, Oral Biosciences, Faculty of Dental Medicine, University of Porto, Porto, Portugal; Researcher at LAQV/REQUIMTE, University of Porto, Porto, Portugal
| | - Maria H Fernandes
- Full Professor, Oral Biosciences and Pharmacology, Faculty of Dental Medicine, University of Porto, Porto, Portugal; Researcher at LAQV/REQUIMTE, University of Porto, Porto, Portugal
| | - João C Sampaio-Fernandes
- Full Professor, Oral Rehabilitation, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Pedro S Gomes
- Associate Professor, Oral Biosciences, Faculty of Dental Medicine, University of Porto, Porto, Portugal; Researcher at LAQV/REQUIMTE, University of Porto, Porto, Portugal.
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Eswaramurthy P, Aras M, DSouza KM, Nagarsekar A, Gaunkar RB. Contemporary Sterilization Protocols of Healing Abutments for Reusability: A Systematic Review. JDR Clin Trans Res 2021; 7:352-359. [PMID: 34617805 DOI: 10.1177/23800844211045897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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.
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Affiliation(s)
- P Eswaramurthy
- Department of Prosthodontics and Crown & Bridge, Goa Dental College & Hospital, Bambolim, Goa, India
| | - M Aras
- Department of Prosthodontics and Crown & Bridge, Goa Dental College & Hospital, Bambolim, Goa, India
| | - K M DSouza
- Department of Prosthodontics and Crown & Bridge, Goa Dental College & Hospital, Bambolim, Goa, India
| | - A Nagarsekar
- Department of Prosthodontics and Crown & Bridge, Goa Dental College & Hospital, Bambolim, Goa, India
| | - R B Gaunkar
- Department of Public Health Dentistry, Goa Dental College & Hospital, Bambolim, Goa, India
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