Reuse of impression copings and healing abutments

Reuse of impression copings and healing abutments is a debatable topic in clinical dentistry.

Dentists can and should reuse impression copings after sterilization.

There are studies using impression copings and scan bodies for dental implant impressions 10 times without distortion after sterilization.  Alikhasi 2013 Sawyers 2019 IJOMI Seems to be common sense to me but some use new every-time, inflating the already high cost of implant dentistry.

 The reuse of healing abutments is more controversial

Some studies show that there is protein on healing abutments even after cleaning and sterilization. However, proteins are not infectious agents (except for the very rare thing like mad cow). They did not test other things we routinely use that go in the mouth, like extraction forceps. Furthermore, almost everything that we use in dentistry will have same results, so what is the point? Medicine has these same proteins on their instruments and no offense to our profession but their stuff is typically far more critical. Lipscomb 2006  Sánchez-Garcés 2019 Furthermore, we ad sterile proteins to patients all the time in the form of bone grafts from cadavers.

Our sterilization process is proven safe and effective. This concern is basically questioning sterilization due to proteins on the abutments. These proteins are going to be present on everything else we use. Most likely this this is someone who is just looking to get a publication or is somehow in a relationship with companies that sell implant parts. Waghwani 2015

If proteins are a concern, what can we do?

However, there are ways to ensure they are free from proteins as well. Kyaw IJOI 2022 To remove protein remnants you can place the healing abutment in 5.25% sodium hypochlorite solution and ultrasonic for 15 min. Then do an electrochemical cleaning using carbon as electrodes, with healing abutments on cathode, and applying the electric current of 1 A at constant 10 V in 7.5% sodium bicarbonate.  Kyaw 2020 Finally complete the steam autoclaving. Kyaw 2022

Other interesting research on healing abutment use

Another study shows that recycled healing abutments from the companies themselves may not be sterile but I wonder about contamination in their testing method as it was a very small percentage. Cakan We know that healing abutments that we recycle are sterile when done in office. Browne 2012.

A systemic review on the topic shows no evidence of any unfavorable consequences to dental implants or harm to patients. This seems one would think that would mean it is fine. However, they conclude that since reusing is popular it should be avoided. That conclusion seems to make very little sense. Why is a popular technique contraindicated without evidence of harm? Bidra JPros2020