Release of Irretrievable Abutment Healing Caps Using Cooling: Proof of Concept and Clinical Recommendations

To study the relation between irretrievable abutment healing caps (AHCs), temperature, and the torque required to remove the AHCs from implants.

Twenty implants, 13 mm long and 4.2 mm in diameter, were inserted into four acrylic boxes and covered with acrylic resin. An AHC was screwed into each implant, using a 30 N/cm torque. The acrylic blocks were placed in a 37°C water bath, and subsequently, a block was removed from the bath, the AHCs were cooled, and the torque needed to release each AHC from the implant was measured using a torque wrench. The cooling methods applied were contact with an ice cube for 10 or 25 seconds or spraying of endodontic refrigerant spray for 3 seconds. The control abutments were similarly tested, but without prior cooling.

The application of ice cubes for 10 seconds reduced the mean releasing torque from 29.60 ± 1.22 N/cm to 28.55 ± 1.96 N/cm (P = .01). Cooling the AHCs with ice cubes for 25 seconds reduced the mean required releasing torque from 29.6 N/cm to 27.85 ± 1.22 N/cm (P < .001). Cooling the same abutments using endodontic refrigerant spray for 3 seconds reduced the mean releasing torque to 27.74 ± 2.13 N/cm (P < .001).

Within the limitations of this study, it is possible to conclude that cooling the AHC reduces the torque required for its release from the implant. This finding may also be relevant to the removal of prosthetic abutments with irretrievable screws.