Odor when healing cap or abutment removed: what do you do?
I am sure we have all had this same experience: you remove a cover screw, healing cap or temporary abutment and notice a foul odor coming out of the implant screw hole. Sometimes even the patient will comment about it. Often the retaining screw will have blood on it. I have noticed this in delayed loading cases as well. I have always simply restored these cases with no apparent ill effects. I have attributed this to necrotic cellular debris and anaerobes down in that little hole. My question to all out there is this: do any of you irrigate the implant screw hole before placing the final abutment? If so, why? What is your protocol? I have never seen this discussed or read any literature on the subject. Should we even care?
10 Comments on Odor when healing cap or abutment removed: what do you do?
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Suhas Vaze
5/17/2016
I always irrigate with N S. It becomes clean and there is no harm. It is inexpensive as well.
Ed DErgosits
5/18/2016
Normal saline is good but why not irrigate with an antibacterial like chorhexidene or benzalkonium chloride with additional sonic agitation?
Jacques Benizri
5/17/2016
I place the tip of my air polisher and I rinse with sodium bicarbonate 3 seconds and it's done and clean.
Alejandro Berg
5/17/2016
We usually use metronidazol (a 1cc vial) and irrigate inside the impant.... cheers
Alejandro Berg
5/17/2016
sorry I forgot, for those of us that are old enough to remember, there was a time when we placed neosporin gel or ofthalmic ab on the thread of the primary cap during initial surgery to avoid this smell.... just a reminder of old times ( this had no statistic influence on the survival of the implants)
Nick Southall DMD
5/17/2016
I generally don't see this with platform switch, conical connection.
natalino guarasci
5/18/2016
I agree with you:conometric connections (Morse cone) don't permit any bacterial colonization of the implant/abutment connection..imagine the longstanding adversal effects of this colonization against crestal bone on the definitive abutments and restorations!
John Seward
5/18/2016
We use ozonated water to clean out, works a treat!
Jalil Sadr, DMD, MSD
5/20/2016
I use chorhexidene always, no harm with it. it makes you feel sure and better. Also, I have patient to resins with it before removing screw. we clean disinfected the screw for later on use.
Jacob Froerer
5/23/2016
Great heads up! With the ease of use with Chlorhexidine, I will ensure a good dental implant outcome for my patients.
