EADT eV expert discussion 2016 in collaboration with the FZT
On October 10, 2016, an expert discussion by EADT eV took place in Frankfurt am Main. In collaboration with the FZT eV, the participants addressed a current issue from everyday dental laboratory work. Based on scientific studies, a possible process for the post-processing and cleaning of individual implant prosthetic components was discussed.
The recommendation developed during the expert discussion is intended to provide the dental technician with a practical and reproducible workflow for achieving a pure abutment that is recognized according to general guidelines.
Do implant abutments need to be sterilized?
From a statement from the DAHZ [DAHZ, Jatzwauk, L., Al-Nawas B.]: “In 2013, an Italian working group led by Luigi Canullo published a clinical study on the preparation of abutments [1]. He compared the clinical results after two different preparation methods of abutments before they were inserted into the patient. In one group the abutments were treated with hot steam, in the other group using an argon plasma reactor. After two years, there was a significantly higher peri-implant bone loss in the group treated with hot steam compared to the group after plasma treatment of the abutments. The magazine's editor, Marco Esposito, addressed this question in his editorial and concluded that abutments should generally be cleaned and sterilized before insertion [2]. This requirement was taken up at the training course organized by the German Medical Publishers on February 15, 2015 in Frankfurt am Main and demanded: “Abutments and all “built-in parts” must be cleaned and free of germs. Because these are medical devices that can be classified as semi-critical and critical. Before reprocessing, the practitioner must carry out a risk assessment [4] as to whether he classifies these parts as semi-critical (“contact with mucous membrane”) or critical (…). In the same year, the demand for sterilization of abutments was contradicted [3]. The reason for this was that the treatment with steam, which only lasts 5 seconds, is neither a recognized cleaning or disinfection process nor is the argon plasma process an effective sterilization process for medical devices. Further scientific studies on the reasons for the differences in peri-implant bone loss between the differently (in)effectively disinfected/sterilized abutments have not been published to date.”
Expert discussion: Dental preparation and cleaning processes for implant abutments
The clinically necessary and practically sensible preparation and cleaning procedures for implant abutments are heavily discussed, as already shown in the problem statement above. Basically, by definition, abutments are medical devices and form the transition from the implant through the soft tissue into the oral cavity. Before use, a risk assessment should therefore be carried out and an assessment should be made as to whether the implant abutments are classified as semi-critical (contact with mucous membrane) or critical (penetration of skin or mucous membrane and in contact with blood or blood) in accordance with the guidelines of the Robert Koch Institute (RKI). . internal tissues). Based on three theses, eight dental technology issues were discussed during the expert discussion and a status quo was defined.
THE EXPERT RECOMMENDATION DEVELOPED WILL BE PUBLISHED SOON AND PUBLISHED ON THE WEBSITE AND IN THE SPECIALIZED MEDIA.
- Canullo L, Peñarrocha D, Clementini M, Iannello G, Micarelli C. Impact of plasma of argon cleaning treatment on implant abutments in patients with a history of periodontal disease and thin biotype: radiographic results at 24-month follow-up of a RCT. Eur J Oral Implantol, 2013; 6(3), 251-260
- Esposito M. On cleaning and sterilization of customized abutments and disappearing implant failures. Eur J Oral Implantol. 2013;6(3):211
- Kern, M. On the scientific evidence that the sterilization of customized implant abutments is required. Eur J Oral Implantol. 2015;8(3):219
- Commission for Hospital Hygiene and Infection Prevention at the Robert Koch Institute. Hygiene requirements when reprocessing medical devices. Federal Health Gazette 44 (2001) 11 ; 1115-1126