Evaluation of the sealing capability of the implant healing screw by using real time volatile organic compounds analysis: Internal hexagon versus cone Morse

BACKGROUND: Implant sealing capability is a crucial issue in assessment of implant success and peri-implant marginal bone loss. Clinical studies demonstrated presence of viable bacteria in the internal part of functioning implants during tissue healing. For this study, a volatile organic compounds (VOCs) emission test was developed to evaluate the existing "seal" between implant and healing screw. Two kinds of implant-screw connection were compared: 1) internal hexagon; and 2) cone Morse. METHODS: Fifteen patients were enrolled in the study, three males and 12 females, who required fixed prosthetic rehabilitation. A total of 37 implants was placed, 23 with a cone Morse taper internal connection and 14 with a screw-retained internal hexagon abutment. VOCs real-time measures were performed in the implant site immediately after removing the healing screw. RESULTS: Statistical analysis was carried out. Results showed VOCs maximum peak amplitude in cone Morse versus internal hexagon showed significant difference (P <0.001), whereas VOCs time to peak showed no significant difference (P = 0.7). CONCLUSIONS: Use of the new methodology for the VOCs emission test may lead to important new data for understanding how the "failed" attachment of implant components, in two-part assemblies, may contribute to implant losses. In particular, study results support the hypothesis that the microgap of the implant-screw healing junction could cause differences in bacterial penetration. VOCs emission test evaluation represents a new diagnostic tool with an effective approach to quickly analyze, in real time, sealing capability of dental implants with healing screw interfaces.