Ultrasonication in 1% sodium hypochlorite effectively decontaminates retrieved titanium healing abutments in lab study
This laboratory randomized controlled trial evaluated the cleaning efficacy of different decontamination protocols on 95 retrieved titanium healing abutments (HAs) from patients after 4-6 weeks. The intervention groups compared ultrasonication (US) in various chemical solutions at different temperatures (40°C 1% sodium hypochlorite [SH], 40°C tap water, 80°C citric/maleic/lactic acid solution, 40°C enzymatic detergent [ED]) followed by autoclaving against a control of autoclaving only. The primary outcome was debridement potential, measured by residual stained area.
The SH protocol demonstrated superior cleaning efficacy, removing a mean of 99.7% of debris (Brand1: 99.6%, Brand2: 99.9%), which was statistically significant (p < 0.05) compared to other groups. The control group (autoclaving only) showed the lowest debridement potential with a mean of 54.4% residual contamination. Secondary analysis of surface morphology and elemental composition via SEM and EDX found that surfaces decontaminated with SH were similar to unused HAs, suggesting minimal alteration.
No safety, tolerability, or adverse event data were reported as this was a laboratory study on retrieved devices. The key limitation is that this was an in vitro experiment without clinical patient outcomes or validation of the protocol's effect on subsequent implant success. The authors suggest that after precleaning with ED, the SH-US-autoclave protocol may present an efficient, cost-effective alternative for at least one reuse cycle when placing new HAs is not feasible, but this remains a laboratory finding.