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Title Contamination of Re-used Healing Abutments May Lead to Altered Oral Cell Attachment
Clinical Question In patients undergoing dental implant surgery, could the re-use of healing abutments as compared to brand new healing abutments alter the way oral cells interact with the healing abutments?
Clinical Bottom Line For patients undergoing dental implant surgery, re-used healing abutments may alter the way some oral cell types attach to the surface compared to new healing abutments, but it is not known if this has clinical implications.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 31453645Bidra/2019300 healing abutments/ 6 case control studiesSystematic review of non-randomized trials
Key resultsThis systematic review of existing in vitro studies found that re-used healing abutments were sterile but were found to have dead cell contamination on their surfaces. The evidence shows that routine methods of cleaning and sterilizing healing abutments are effective against live bacteria but may not remove all contaminants.
#2) 32944837Jain/202021 healing abutmentsLaboratory Study
Key resultsEpithelial cells that have been cultured on re-used healing abutments exhibit a significant decrease in viability when compared to unused healing abutments, but fibroblasts did not. Cell viability of keratinocytes decreased by >100% from day 1 to day 7 in culture.
Evidence Search healing abutment AND (re-use OR contamination)
Comments on
The Evidence
Validity: Bidra et al. 2019 systematically reviewed current literature based on predetermined inclusion and exclusion criteria. Included articles were only from English language peer-reviewed journals. The six articles included in the review did not contain quantitative data, so no meta-analysis was performed. Of the six articles, five showed that traditionally sterilized healing abutments did not result in complete decontamination of the healing abutment. Notably, this is a low level of evidence because the systematic review was based on benchtop and not human studies. The study conducted by Jain et al. 2020 provided in vitro evidence of the differences in cellular attachment to new and re-used healing abutments. Again, this is a low level of evidence due to the benchtop design. Perspective: Further studies in humans are needed to determine if these alterations in attachment have clinical ramifications. Future study designs should determine if these contaminants could play a role in immune activation in humans.
Applicability The re-use of healing abutments has been long practiced in implant dentistry for efficiency. It is important to have evidence that these cost saving methods do not affect clinical healing.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics)
Keywords Healing abutment, disinfect, sterilize, re-use, implant
ID# 3452
Date of submission: 11/25/2020spacer
E-mail breard@uthscsa.edu
Author Brandon Breard
Co-author(s) Loc Tran
Co-author(s) e-mail tranlv@livemail.uthscsa.edu
Faculty mentor/Co-author Dr. Georgios Kotsakis
Faculty mentor/Co-author e-mail kotsakis@uthscsa.edu
Basic Science Rationale
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