The Journal of Advanced Prosthodontics

The Korean Academy of Prosthodonitics (대한치과보철학회)
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Microbiological cleaning and disinfection efficacy of a three-stage ultrasonic processing protocol for CAD-CAM implant abutments

  • Gehrke, Peter (Department of Postgraduate Education, Oral Implantology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe University) ;
  • Riebe, Oliver (HygCen Germany GmbH) ;
  • Fischer, Carsten (Sirius Ceramics Laboratory) ;
  • Weinhold, Octavio (Oral Surgery and Implant Dentistry) ;
  • Dhom, Gunter (Oral Surgery and Implant Dentistry) ;
  • Sader, Robert (Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt) ;
  • Weigl, Paul (Department of Prosthodontics Department of Postgraduate Education, Oral Implantology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe University)
  • Received : 2022.05.03
  • Accepted : 2022.09.27
  • Published : 2022.10.31
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Abstract

PURPOSE. Computer-aided design and manufacturing (CAD-CAM) of implant abutments has been shown to result in surface contamination from site-specific milling and fabrication processes. If not removed, these contaminants can have a potentially adverse effect and may trigger inflammatory responses of the peri-implant tissues. The aim of the present study was to evaluate the bacterial disinfection and cleaning efficacy of ultrasonic reprocessing in approved disinfectants to reduce the microbial load of CAD-CAM abutments. MATERIALS AND METHODS. Four different types of custom implant abutments (total N = 32) with eight specimens in each test group (type I to IV) were CAD-CAM manufactured. In two separate contamination experiments, specimens were contaminated with heparinized sheep blood alone and with heparinized sheep blood and the test bacterium Enterococcus faecium. Abutments in the test group were processed according to a three-stage ultrasonic protocol and assessed qualitatively and quantitatively by determination of residual protein. Ultrasonicated specimens contaminated with sheep blood and E. faecium were additionally eluted and the dilutions were incubated on agar plates for seven days. The determined bacterial counts were expressed as colony-forming units (CFU). RESULTS. Ultrasonic reprocessing resulted in a substantial decrease in residual bacterial protein to less than 80 ㎍ and a reduction in microbiota of more than 7 log levels of CFU for all abutment types, exceeding the effect required for disinfection. CONCLUSION. A three-stage ultrasonic cleaning and disinfection protocol results in effective bacterial decontamination. The procedure is reproducible and complies with the standardized reprocessing and disinfection specifications for one- or two-piece CAD-CAM implant abutments.

Keywords

Acknowledgement

The authors gratefully acknowledge Jochen Schlenker for his support and valuable advise as well as Patrick Muhlbeyer for his excellent technical assistance. The authors thank BEGO Medical GmbH for providing the test samples for the experimental investigation.

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