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Ultrasonication in 1% sodium hypochlorite effectively decontaminates retrieved titanium healing abutments in lab study

Ultrasonication in 1% sodium hypochlorite effectively decontaminates retrieved titanium healing abut…
Photo by RephiLe water / Unsplash
Key Takeaway
Consider lab evidence for SH ultrasonication protocol for HA decontamination; clinical validation needed.

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.

Study Details

Study typeRct
EvidenceLevel 2
PublishedApr 2026
View Original Abstract ↓
BACKGROUND: Potential effectiveness of ultrasonication (US) with different chemical solutions on the decontamination of titanium implant healing abutments (HAs) and their surface characteristics was investigated. METHODS: Ninety-five HAs, representing two distinct brands/designs, were retrieved from patients after 4-6 weeks for the present study. They were precleaned by immersing in enzymatic detergent (ED) and randomized into five groups: autoclaving only (control), US in 40°C tap water and autoclaving, US in 40°C 1% sodium hypochlorite (SH) and autoclaving, US in 80°C citric + maleic + lactic acid (CA) solution and autoclaving, US in 40°C ED and autoclaving. HAs were stained and photographed from lateral and occlusal aspects before and after decontamination. Stained areas were calculated and scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX) analyses were conducted to assess surface morphology and elemental composition. RESULTS: Control group showed the lowest debridement potential (mean 54.4%) and highest residual contamination. SH almost entirely removed the debris (mean 99.7%, Brand1: 99.6%, Brand2: 99.9%) showing an outperforming cleansing efficacy among all groups (p < 0.05). SEM and EDS analyses demonstrated that surface morphology and elemental composition of decontaminated surfaces in SH group was similar to that of unused HAs. CONCLUSION: After precleaning HAs by soaking in ED, 1% SH, used in combination with US, can be preferred for decontaminating HAs due to its superior cleaning efficiency and minimal surface alteration regardless of HA macrogeometry. In cases where placing unused HAs is not feasible, this three-step protocol may present an efficient and cost-effective alternative for at least one reuse cycle.
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