Gehrke Peter, Riebe Oliver, Fischer Carsten, Weinhold Octavio, Dhom Günter, Sader Robert, Weigl Paul
Department of Postgraduate Education, Master of Oral Implantology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe University, Frankfurt, Germany.
Private Practice for Oral Surgery and Implant Dentistry, Ludwigshafen, Germany.
J Adv Prosthodont. 2022 Oct;14(5):273-284. doi: 10.4047/jap.2022.14.5.273. Epub 2022 Oct 28.
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.
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 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).
Ultrasonic reprocessing resulted in a substantial decrease in residual bacterial protein to less than 80 µg and a reduction in microbiota of more than 7 log levels of CFU for all abutment types, exceeding the effect required for disinfection.
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.
种植体基台的计算机辅助设计与制造（CAD-CAM）已显示会因特定部位的铣削和制造工艺导致表面污染。若不清除这些污染物，可能会产生潜在的不良影响，并可能引发种植体周围组织的炎症反应。本研究的目的是评估在经批准的消毒剂中进行超声再处理对降低CAD-CAM基台微生物负荷的细菌消毒和清洁效果。
通过CAD-CAM制造了四种不同类型的定制种植体基台（总数N = 32），每个测试组（I型至IV型）有八个样本。在两个单独的污染实验中，样本分别仅用肝素化羊血以及肝素化羊血和测试细菌粪肠球菌进行污染。测试组中的基台按照三阶段超声方案进行处理，并通过测定残留蛋白进行定性和定量评估。用羊血污染的超声处理样本另外进行洗脱，稀释液在琼脂平板上培养七天。测定的细菌计数以菌落形成单位（CFU）表示。
超声再处理导致所有基台类型的残留细菌蛋白大幅降低至低于80μg，微生物群减少超过7个对数水平的CFU，超过了消毒所需的效果。
三阶段超声清洁和消毒方案可有效进行细菌去污。该程序具有可重复性，符合单件或两件式CAD-CAM种植体基台的标准化再处理和消毒规范。
