Dental implant healing abutment decontamination: A systematic review of in vitro studies

PURPOSE

To investigate various cleaning protocols employed to enable the reuse of healing abutments in the past decade.

MATERIALS AND METHODS

The review followed the guidelines set out in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, with guidance from the Cochrane Collaboration Handbook. Electronic searching and handsearching were performed using the National Library of Medicine (MEDLINE via PubMed) and the Cochrane Central Register of Controlled Trials from January 2010 to July 2022, respectively. Studies published in English were evaluated. Two independent examiners conducted the search and the review process. The risk of bias of the included studies was evaluated.

RESULTS

In total, 178 articles were evaluated for review, but only 15 of them were selected for full-text reading. Regarding cleaning efficacy, chemical decontamination using sodium hypochlorite produced better results than laser and mechanical decontamination with airflow. Similar efficacy was found between chemical and electrochemical decontamination. Combined use of chemical and electrochemical decontamination protocols demonstrated the greatest efficacy. Chemical and electrochemical decontamination methods were found to achieve better outcomes in preserving the surface properties of decontaminated healing abutments than laser and mechanical methods.

CONCLUSION

The present review found that combined decontamination protocols (chemical, electrochemical processing and autoclave treatment) are favourable for obtaining healing abutments with optimally cleaned surfaces. Moreover, healing abutments located in an area that is difficult to access can be cleaned without affecting the surface properties. This information could benefit researchers and clinicians when multiple-use healing abutments are considered.

The Effectiveness of Waist-Shaped and Straight-Shaped Interdental Brushes in Cleaning Implant Overdenture Attachments: A Self-Controlled Clinical Trial

Elderly patients often find it challenging to remove plaque accumulated on the attachments of implant overdentures (IODs) using conventional cleaning instruments. Further, excessive plaque accumulation can lead to peri-implant diseases and occasionally to respiratory diseases. Therefore, here, we aimed to compare the effectiveness of waist-shaped interdental brushes (WIBs) with that of straight-shaped interdental brushes (SIBs) in plaque removal from the locator attachments of IODs. Twenty participants with 2 locator attachments retaining mandibular IODs participated in this study. After the baseline cleaning, the participants refrained from oral hygiene maintenance for 3 days. A dentist cleaned 1 of the attachments using the WIB and the other attachment using the SIB. The pre- and post-cleaning modified plaque index (mPLI) scores were recorded. After another 3 days free from oral hygiene maintenance, the trained participants repeated the same cleaning procedure using the WIB and SIB. Pre- and post-cleaning mPLI scores were recorded. Regardless of the type of brush used, the post-cleaning mPLI scores were lower than the pre-cleaning scores. After the cleaning procedure, the overall mean mPLI score was lower in the WIB group than in the SIB group. The post-cleaning mPLI scores at the line angles and on the axial surfaces of the attachments were also lower in the WIB group than in the SIB group. There was no difference in the cleaning effectiveness between the dentist and participants when they used the same type of interdental brush. The WIB was significantly more efficient in plaque removal than the SIB, especially at the line-angle sites.

Effects of air abrasive decontamination on titanium surfaces: A systematic review of in vitro studies

BACKGROUND

Air abrasion (AA) is one of the decontamination methods that have demonstrated promising results in treating peri-implant diseases.

PURPOSE

This systematic review aimed at evaluating the in vitro effect of AA on surface change, cleaning efficacy, and biocompatibility of titanium surfaces and at comparing it with other decontamination methods.

MATERIALS AND METHODS

A comprehensive search was conducted up to April 2018 using PubMed, Scopus, and Google Scholar databases to identify studies on the decontamination effect of AA. All types of titanium surfaces, abrasive powders, contaminated surfaces, and measuring methods were included.

RESULTS

Overall, 1502 articles were identified. After screening the titles and abstracts, and carefully reading the full-texts, 48 articles published between 1989 and 2018 were selected. AA was considered almost safe, particularly for the nonmodified surfaces. Nevertheless, harder powders such as sodium bicarbonate tended to damage the surface more than glycine. AA resulted in surface change similar to plastic curettes and Er: YAG lasers. Regarding the cleaning efficacy, there was no significant difference between glycine and sodium bicarbonate, but different mixtures of calcium phosphate, hydroxyapatite, and erythritol were superior to glycine. AA was superior or equal to all other decontamination methods in cleaning. Regarding biocompatibility, AA was more successful in preserving biocompatibility for noncontaminated surfaces compared with contaminated surfaces and when used with erythritol and osteoinductive powders.

CONCLUSIONS

AA can efficiently remove contamination without serious damage to the surface. The main drawback of the AA method seems to be its limitation in restoring the biocompatibility of the surface.