Should Healing Abutments and Cover Screws for Dental Implants be Reused? A Systematic Review.

PURPOSE: To systematically review the current scientific evidence to assess if healing abutments and cover screws for dental implants can be resterilized effectively for reuse. A secondary purpose was to investigate if there has been any reported adverse biological or mechanical consequences to implants, or harm to patients with the reuse of healing abutments or cover screws. MATERIALS AND METHODS: An electronic search of the English language scientific literature was performed independently by multiple investigators using a systematic search process using the PubMed search engine and Cochrane database. After the application of predetermined inclusion and exclusion criteria, the final list of articles was reviewed to meet the various objectives of this review. RESULTS: The initial electronic search resulted in 657 titles and after the application of predetermined inclusion and exclusion criteria, six articles were identified that satisfied the study objectives. All six articles were observational studies that described a total sample of over 300 used healed abutments obtained from patients. Out of these, three studies showed that routine methods (mechanical, chemical, and steam) used for cleaning and sterilizing used healing abutments did not result in the complete removal of contaminants, while two studies showed that routine methods supplemented with an additional regimen resulted in adequate decontamination. One additional study showed that routine methods sufficiently resulted in adequate decontamination of used healing abutments. There were no true clinical studies identified. There were no studies identified in the literature that reported on any adverse consequences to dental implants, such as infections, bone loss, mechanical complications, implant failure, or harm to patients, by reuse of healing abutments or cover screws. CONCLUSIONS: Limited evidence suggests that routine methods used for cleaning and sterilization of used titanium healing abutments may not result in the complete removal of contaminants. However, the biological or mechanical implication of this finding is yet to be determined because presently there are no reports in the literature related to any unfavorable consequences to dental implants, or harm to patients by reuse of healing abutments or cover screws. Nevertheless, due to the popular clinical practice of reusing healing abutments to reduce cost to clinicians and patients, indiscriminate reuse of healing abutments should be avoided, until further supporting evidence is established.

Estimation of levels of salivary mucin, amylase and total protein in gingivitis and chronic periodontitis patients.

BACKGROUND: Periodontal diseases are a group of inflammatory conditions resulting from interaction between a pathogenic bacterial biofilm and susceptible host's inflammatory response eventually leading to the destruction of periodontal structures and subsequent tooth loss. Hence, investigation of salivary proteins in individuals with periodontal diseases may be useful to enhance the knowledge of their roles in these diseases. MATERIALS AND METHODS: This case-control study was conducted at A.B. Shetty Memorial Institute of Dental Sciences, Mangalore. The study comprised of 90 patients of age between 25-60 years who were clinically examined and divided into three groups of 30 each: namely clinically healthy, gingivitis and chronic periodontitis. These were classified according to the values of gingival index score, clinical attachment loss and probing pocket depth. Unstimulated saliva was collected and salivary mucin, amylase and total protein levels were determined. STATISTICAL ANALYSIS: RESULTS obtained were tabulated and statistically analyzed using ANOVA test and Karl pearson's correlation test. RESULTS: The results of the study showed an increased concentration of salivary mucin, amylase and total protein in gingivitis patients and increased levels of amylase and total protein in saliva of chronic periodontitis patients compared to healthy individuals which were statistically significant. A decrease in mucin concentration was observed in the periodontitis group compared to gingivitis group. A positive correlation was present between salivary mucin, amylase and total protein levels in the three groups. CONCLUSION: Salivary mucin, amylase and total protein may serve as an important biochemical parameter of inflammation of the periodontium. Also, it can be hypothesized that various enzyme inhibitors might be useful as a part of host modulation therapy in the treatment of periodontal diseases.