Bacterial Leakage in Implants With Different Implant–Abutment Connections: An In Vitro Study

Abstract

Two-piece implants present gaps and cavities between the implant and the abutment, and these hollow spaces can act as a trap for bacteria. The aim of the present in vitro study was to evaluate the migration of two different microbial species from the inside to the outside of the implant-abutment assembly in three different connection types. A total of 30 implants (10 implants per group) were used. The implants presented a screwed trilobed connection (group 1), a cemented connection (group 2), and an internal conical connection (group 3). The inner parts of five implants, per group, were inoculated with Pseudomonas aeruginosa suspension and the remaining five implants, per group, with Aggregatibacter actinomycetemcomitans. The penetration of bacteria into the surrounding solution was determined by the observation of turbidity of the broth. In group 1, bacterial contamination was found in six of 10 implants. In group 2, no contaminated samples were found. In group 3, bacterial contamination was found in one implant of 10. Statistically significant differences were detected between group 1 versus group 3 (P <0.05) and between group 1 versus group 2 (P <0.01), whereas no significant differences were found when comparing group 2 versus group 3 (P >0.05). The present study confirms previous results about the hermeticity of the cement-retained implant-abutment assembly, the very low permeability to bacteria of the conical implant-abutment connection, and the high prevalence of bacterial penetration of screw-retained implant-abutment assemblies.