Partner Magazine logo 16

logo 16 • the CAMLOG Partner Magazine • June 2017 logo 16 • the CAMLOG Partner Magazine • June 2017 22 23 individual abutments does not remove the particles – which are macroscopically hardly visible – from the surface. Possible procedure Our own initial in-vitro investigations demonstrated that ultrasonically cleaned and disinfected abutments show a clear reduction in surface contamination. We therefore recommend to subject all abutments to a standardized cleaning and disinfection procedure prior to insertion in the patient. In order to ensure a clean and hygienically perfect abutment surface, we follow a systematic three-stage cleaning protocol (Finevo washing protocol) (Fig. 11) . Then the hygienically cleaned abutments are sealed and supplied to the dental practices. We have defined a roadmap within our team. The individual work steps are documented exactly. Three-stage cleaning protocol for abutment hygiene The standardized processing protocol presented here has been well established in our process and has proven itself. The procedure is simple and feasible, which may prove to be a valuable argument in everyday practice or laboratory routines. The abutment is cleaned successively in an ultrasonic bath in three different cleaning liquids for ten minutes at 60 °C. The first step is the disinfection in an an- tibacterial cleaning liquid (Finevo, sirius ceramics, Frankfurt am Main). Then the object is placed in 96% ethyl alcohol and rinsed for a further ten minutes in the ultra- sonic bath. After subsequent cleaning with pure medical distilled water, the assembly is sealed and supplied to the dental practice. This three-stage ultrasonic cleaning pro- tocol has delivered excellent results in our in-vitro studies for the cleaned surfaces (test group) compared with surfaces cleaned with a steam vaporizer (control group). Conclusion The implant-prosthetic treatment team should be aware that implant abutments are medical devices that have to meet certain criteria. Dental technicians in particular are therefore faced with a new range of tasks which they should take on responsibly. And even if the answers are still limited for many questions and the need for research exists, the fact remains: the treatment team should define a clear routine procedure that corresponds to current knowledge and legal requirements. It should be determined jointly who is CASE STUDY CASE STUDY Figs. 10 and 11: Standardized three-stage cleaning process with a washing protocol in the ultrasonic bath. Figs. 12 and 13: Contaminated components before and after 3-stage cleaning. Source of images: Gehrke P, Tabellion A, Fischer C. J Adv Prosthodont. 2015, Apr;7(2):151–9 [1] Canullo L et al. Hard tissue response to argon plasma cleaning/ sterilization of customized titanium abutments versus 5-second steam cleaning: results of a 2-year post-loading follow-up from an explanatory randomized controlled trial in periodontally healthy patients. Eur J Oral Implantol, 2013;6: 251–260 [2] Canullo L, et al. Microscopical & microbiologic charac- terization of customized titanium abutments after different cleaning procedures. Clin. Oral Impl. Res. 2012 Dec 5 [3] DIN EN ISO 17664:2016–06. Berlin: Beuth, 2016 [4] EADT e.V., Zahntechnische Aufbereitungs- und Reini- gungsverfahren von Implantat-Aufbauten, Zusammenfassung einer Experten-Diskussion, www.eadt.de , März 2017 [5] Gehrke P, Tabellion A, Fischer C. Microscopical & chemical surface characterization of CAD/CAM zirconia abutments after different cleaning procedures. A qualitative analysis. J Adv Prosthodont. 2015, Apr;7(2):151–9 LITERATURE Possible sources of process impurities: • Cooling liquid from the CAM process • Milling chips • Blasting material • Grease • Polishing agent • Palladium milling residue • Sulfuric acid in case of zirconium abutments • Adhesive residue • Rubber residues Cleaning protocol The following washing units are performed in the high-frequency ultrasonic bath heated to 60 °C for ten minutes each: 1. A ntibacterial cleaning solution (Finevo 01, Sirius Ceramics, Frankfurt/Main) 2. Ethyl bath (96% ethyl alcohol) 3. Pure medical distilled water 4. Sealing of cleaned abutment Carsten Fischer Carsten Fischer has been a self-employed dental technician since 1996 in a specialist company in Frankfurt/Main. He has been an active international speaker since 1994 and underlines this activity with publications in numerous countries (Brazil, Argentina, Japan, Australia, Europe). Carsten Fischer is a member of various advisory boards and has acted as an advisor to renowned companies in the dental industry for many years. He focuses on CAD/CAM technologies, the ceramic double crown, customized abutments, and full ceramic materials. Carsten Fischer also worked as a part- time assistant at the Goethe University Frankfurt from 2012 to 2014 and continues his close cooperation. His contribution was honored as best lecture at the ADT by the Working Group Dental Technologies 2013. Carsten Fischer is a lecturer at the Steinbeis University of Applied Sciences, Berlin, and speaker for various organizations (DGI) as well as Vice President of the EADT. Contact details sirius ceramics | Carsten Fischer Lyoner Straße 44-48 60528 Frankfurt, Germany Phone: +49 69 66366910 info@sirius-ceramics.com Contact details Dental practice Prof. Dr. Dhom & Colleagues Bismarckstr. 27 and Berliner Platz 1 67059 Ludwigshafen, Germany Phone: +49 621 68124444 Dr. med. dent. Peter Uwe Gehrke After studying dentistry at the Free University Berlin, Dr. Peter U. Gehrke received his license to practice in 1991 and graduated as Dr. med. dent. in 1992. After receiving a scholarship from Schering AG, Pharmaceutical Industries, Dr. Gehrke set up a private dental practice in Hamburg. This was followed by postgraduate studies at the New York University College of Dentistry in the Restorative & Prosthodontic Sciences Department of Implant Dentistry. After positions as Marketing Manager and Senior Manager Medical Marketing in the implant industry, Dr. Gehrke joined the oral surgery practice Prof. Dr. Dhom & Colleagues in Ludwigshafen. Dr. Gehrke focuses on implant dentistry and esthetic dentistry. In addition he is a lecturer at Steinbeis University of Applied Sciences, Berlin, for the Master of Science course in oral implant dentistry and periodontal therapy. Dr. Gehrke is co-author of the text book “Fundamentals of Esthetic Implant Dentistry” (Blackwell Publishing Company) and co- editor of ZZI of the DGI. AUTHORS responsible for which step, and how documentation is to be performed. We fully comply with the three-stage cleaning protocol. The procedure is practice-oriented and financially acceptable and the results comply with the recommendations existing for the present status of knowledge.