Effects of multiple implantations of titanium healing abutments: Surface characteristics and microbial colonization

• Published in: Dental materials Vol. 36; no. 9; pp. e279 - e291
• Main Authors: Jain, Sanjana S., Schramm, Sareda T.J., Siddiqui, Danyal A., Huo, Wenwen, Palmer, Kelli L., Wilson, Thomas G., Rodrigues, Danieli C.
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01-09-2020; Elsevier BV
• Subjects: 16S rRNA; Abutments; Bacteria; Bacterial corrosion; Biological contamination; Biological materials; Cleaning; Colonization; Contouring; Corrosion; Corrosion rate; Dental Abutments; Dental Implants; Dental materials; Discoloration; Electrochemistry; Healing; Microbiome; Microbiomes; Microbiota; Oral cavity; Reuse; RNA, Ribosomal, 16S; rRNA 16S; Scanning electron microscopy; Sequence analysis; Soft tissue; Soft tissues; Sterilization; Surface analysis (chemical); Surface Properties; Titanium; Wound healing; Oral cavity; 16S rRNA; Sterilization; Reuse; Bacteria; Soft tissue; Abutments; Microbiome
• ISSN: 0109-5641; 1879-0097
• DOI: 10.1016/j.dental.2020.05.016

•- Minimal focus is placed on IHAs, despite its vital role in soft tissue healing/shaping after dental implant body placement.•IHAs, which are designed and labeled for “single” use, are re-used in multiple patients as a common clinical practice.•Microbial analysis and surface characterization of IHA retrievals was performed after single and multiple implantations.•Streptococcus was the only genus present on every IHA, while Fusobacterium had the highest relative frequency across all IHAs.•IHA retrievals showed discoloration, abrasions, biological contamination, and higher corrosion rate as compared to controls.
Very few studies have investigated dental implant components involved in the early stage of healing, especially the implant healing abutment (IHA), despite its vital role in soft tissue contouring and shaping after implant placement. Although these components are labelled by the manufacturer for “single-use only,” it is a common clinical practice to clean, sterilize, and reuse them.
In the present study, IHAs after single and multiple implantations were retrieved as per standard procedures, and biological material isolated from the surface was subjected to 16S rRNA sequence analysis. The microbiome analysis was followed by cleaning and sterilization in order to replicate clinical sterilization techniques. Following sterilization, retrievals were subjected to surface characterization with optical and scanning electron microscopy to investigate surface features, and electrochemical testing was performed to evaluate corrosion behavior.
The microbiota was comprised of early colonizers including Streptococcus species and secondary anaerobic colonizers such as Fusobacterium, Capnocytophaga, and Prevotella species. The surface analysis revealed that irrespective of the cleaning and sterilization techniques, the pristine, homogeneous surface of the new, unused IHAs could not be restored. Both single and multiple-use IHAs had severe surface changes including discoloration, major abrasions, biological contamination, and the IHA retrievals exhibited higher corrosion rate as compared to control specimens.
Reusing IHAs multiple times may not be a prudent practice as the microbial colonization and surface changes caused by using this component multiple times may affect the performance of IHAs in soft tissue healing.