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

Abstract

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. 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. 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. 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.