Can We Re-Use the Healing Cap or Cover Screw?

I have wrestled with this question many times. From a finiancial standpoint, throwing used healing abutments away is painful. I'm sure that everyone will have their own method of steriliztaion that they can justify as safe and effective way of assuring patient safety. However, I try to treat every patient like I would want to be treated. Personally, I would rather have the new healing abutment right out of the package.

I have always reused my healing abutments, and never had an issue. Looking at it from a surgical point of view, a healing abutment is not being placed in a sterile area. They are intra-oral and not directly involved in osseointegration what is the justification to placing a sterile healing abutment every time? I really don't see any.

The healing abutment needs to be sterile. Whether you use a new one for every patient, or reuse them, it needs to be clean and sterile. The ultrasonic cleaner is a contaminated tank and you can be cross-contaminating instruments and prosthetic components if you don't follow that with rinsing, drying, bagging and autoclaving the items. This is basic infection control!

There is nothing wrong with re-using a healing abutment as long as it is thoroughly cleaned and sterilized. With all due respects to comments from Dr P,nothing should be placed in the mouth unsterilized if it is capable of being sterilized. The healing abutments are used immediately after surgical exposure and therefore it is mandatory that they are sterilized before use, or re-use with a different patient, no ifs or buts!If you aren't sure whether they are sterile, then perhaps you should choose another profession where sterility is not important.

Use a new one. It is included in the patients fee. Use the company that includes the healing abutents and cover screw with the implant.

Dr. Berne is correct. However my point was misunderstood. I was making my point with the use of the same patient. If you unscrew a healing collar, take an impression, and then screw the same healing collar back on, then I do not think it is necessary to sterilize the healing collar. With a different patient then the healing collar needs to be sterilized. Sorry I should have been more clear.

This is so obvious - I can't believe there is a discussion. Healing caps or abutments are OK to reuse if they are sterilized. We reuse and sterilize every other instrument we use and it is in contact with the same tissues. The food and utensils we use regularly in restaurants are touched by non-sterile hands and may or may not be properly cleaned between patrons. The only issue with a healing cap/ abutment is that it should only come out once for the impression. Gingival fibers actually attach to the titaniuim surface and then the final abutment (zirconia or titanium) UNLESS the healing abutment comes in and out a few times, then the fibers will no longer attach. DO you want them to attach if you can? - you bet

Like all things, even the threads of the healing abutment wear over constant re-using. Keep a check on the damage over the threads of the healing abutment to avoid damage to the threads in the implant. Most often the dentist take it for granted while removing a healing abutment since it is a simple procedure.In due process does not handle it with care! Tensile stress on the threads can cause them to elongate(due to repeated and forceful tightening),ultimately causing the threads to give way. Sterilizing and re-using is perfectly OK.

I think there is no harm to reused the healing abutment once it is sterile & not fatigue & there is no over advantage to used new one.

Reuse is no big deal.

there is no point in not re using healing abutment once oseointegration has taken place,in single stage protocol i would use new one.however nobel groovy is not supplied with cover screw & sometimes we use sterelised cover screw of nobel replace select,put aside healing abutment,wich you can certainly use.when we get our lab work with abutment & analog on the models don,t we use them?

dear doctors, each of you is a person that i admire and respect very much and i learn so many thingw from these conversations! i have placed an implant crown on straumann type implant,on an upper 1st premolar and the xray showed it was firmly placed where it should(no problem with the xray of the impression coping either). but after cementing whith temporary cement the xray shows a gap on the mesial and distal site , but so small that allows crown to fit whith no further occlusal adjustment.I beleieve this happened because i decided to leave 4mm of abutment and the high temperature in june. since the first moment i wasnt able to remove the crown without cutting with bur, so i didnt cut it. i watch the patient for 3 months now and i increased the oral hygien istructions. what do you suggest, cut it or wait for slightest sign of inflamation to appear.i am a new periodontologist,Msc, and i am not afraid of inflammation at first stages,and i personally think that the gap is surrounded with firm connective tissue.

Can a crown be placed over a healilng cap/abutment permanently?

This question can be answered by using a metaphor Can you be living permanently under an emergency tent? An healing cap bears a specific purpose to serve. It is not "designed" to perform the functions of an abutment. Although, a healing cap can be used/utilised to support a "PROVISIONAL" crown, not for permanent. amgdds