Evaluation of Residual Contamination on Healing Abutments After Cleaning With a Protein-Denaturing Agent and Detergent

Quintessence Int. 2020;51(6):474-485. doi: 10.3290/j.qi.a44546.


Objective: This study evaluated the cleaning potential of a protein-denaturing agent with or without anionic detergent by monitoring the residual contamination on healing abutments used for dental implant treatment.

Method and materials: Forty contaminated healing abutments removed from patients were randomized and immediately treated with differing cleaning methods; either Method A (presoaking in 1% sodium dodecyl sulfate followed by ultrasonication with 4 mol/L guanidine hydrochloride), or Method B (soaking in distilled water followed by ultrasonication with 4 mol/L guanidine hydrochloride) was used. Samples were stained with phloxine B and photographed using a light microscope. The proportion of stained and contaminated areas on each healing abutment was then calculated using Image J. The surface was examined with a scanning electron microscope and energy-dispersive x-ray spectroscopy.

Results: The percentages of contaminated surfaces of the screwdriver engagement region, upper body, and lower body for methods A and B were 50% and 38%, 10% and 80%, and 38% and 18%, respectively. There was a statistically significant difference (engagement region [P < .001], upper body [P = .043], and lower body [P = .017]; Mann-Whitney) regarding the residually stained areas between the two cleaning methods. No surface alterations were seen by scanning electron microscopy. Energy-dispersive x-ray spectroscopy confirmed that the cleaned surfaces of the healing abutments revealed no signs of organic contamination.

Conclusion: Although the combination of a strong denaturing agent and detergent effectively cleaned contaminated healing abutments, perfect cleaning was not always possible, indicating that the reuse of healing abutments in different patients is not recommended.

Keywords: anionic detergent; decontamination; healing abutments; protein denaturing agent; ultrasonic cleaning.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Dental Abutments
  • Dental Implants*
  • Detergents
  • Humans
  • Microscopy, Electron, Scanning
  • Surface Properties
  • Titanium


  • Dental Implants
  • Detergents
  • Titanium