Re-use of implant coverscrews changes their surface properties but not clinical outcome

This study examined the effect of re-using coverscrews for dental implants (Branemark) and the influence of re-use on clinical outcome. Nine patients, each receiving 3 implants in either the maxilla or the mandible, received 1 new coverscrew, 1 re-used coverscrew, and a third coverscrew that had been used multiple times. In all cases, the re-used coverscrews had been washed, mechanically cleaned, and steam-sterilized prior to re-implantation. Clinical outcome was assessed by X-ray analysis of the mandible/ maxilla and light microscopy of histologically prepared sections of the overlying tissue. The surfaces of the coverscrews were characterized by profilometry, scanning electron microscopy (SEM), Auger electron spectroscopy (AES), and atomic force microscopy (AFM). There was no difference in clinical outcome whether the coverscrews were new or re-used multiple times. Histological evaluation showed no influence of re-use on the overlying epithelial and connective tissues at the time the coverscrew was removed. Surface topography and roughness changed with increasing number of uses, but surface chemistry was virtually unchanged. SEM and AFM analyses revealed the presence of machining marks, as well as deep scratches, across the surface of the re-used coverscrews. This study shows that coverscrews can be cleaned and re-used without any apparent adverse affect on clinical outcome. However, the cleaning procedures, as well as the surgical procedure, change the surface characteristics. If this approach were applied to the implant itself, it might affect osseointegration.