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BioMed Research International
Volume 2016, Article ID 9219071, 6 pages
http://dx.doi.org/10.1155/2016/9219071
Research Article

Leakage of Microbial Endotoxin through the Implant-Abutment Interface in Oral Implants: An In Vitro Study

1Department of Oral Medicine & Periodontology, School of Oral Health Sciences, Faculty of Health Science, University of the Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa
2Clinical Unit, Department of Oral Medicine & Periodontology, School of Oral Health Sciences, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
3Malo Clinic Health and Wellness, Av. dos Combatentes 43A, 1600-042 Lisbon, Portugal
4Research and Development Department, Malo Clinics, Av. dos Combatentes 43A, 1600-042 Lisbon, Portugal
5Oral Hygiene Department, Malo Clinics, Av. dos Combatentes 43A, 1600-042 Lisbon, Portugal

Received 19 September 2016; Revised 24 November 2016; Accepted 12 December 2016

Academic Editor: Elizabeta Gjorgievska

Copyright © 2016 Rhoodie Garrana et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Endotoxin initiates osteoclastic activity resulting in bone loss. Endotoxin leakage through implant abutment connections negatively influences peri-implant bone levels. Objectives. (i) To determine if endotoxin can traverse different implant-abutment connection (IAC) designs; (ii) to quantify the amount of endotoxins traversing the IAC; (iii) to compare the in vitro comportments of different IACs. Materials and Methods. Twenty-seven IACs were inoculated with E. coli endotoxin. Six of the twenty-seven IACs were external connections from one system (Southern Implants) and the remaining twenty-one IACs were made up of seven internal IAC types from four different implant companies (Straumann, Ankylos, and Neodent, Southern Implants). Results. Of the 27 IACs tested, all 6 external IACs leaked measurable amounts of endotoxin. Of the remaining 21 internal IACs, 9 IACs did not show measurable leakage whilst the remaining 12 IACs leaked varying amounts. The mean log endotoxin level was significantly higher for the external compared to internal types (). Conclusion. Within the parameters of this study, we can conclude that endotoxin leakage is dependent on the design of the IAC. Straumann Synocta, Straumann Cross-fit, and Ankylos displayed the best performances of all IACs tested with undetectable leakage after 7 days. Each of these IACs incorporated a morse-like component in their design. Speculation still exists over the impact of IAC endotoxin leakage on peri-implant tissues in vivo; hence, further investigations are required to further explore this.