Fibrin clot adherence on cleaned and decontaminated titanium abutment surfaces: An in vitro study

Osseointegration is now primarily established, but soft tissue integration is still susceptible to failure and problematic on implant surfaces. So, implant dentistry is increasingly focusing on improving peri-implant soft tissue integration.

The present study aimed to evaluate the blood fibrin clot formation and adhesion on the abutment after cleaning and decontamination and determine the suitable abutment surface associated with fibrin clot attachment.

Forty-two abutments (14 per group) were used in the present study: a brand-new (BN), contaminated with biofilm (CO) and decontaminated with an enzymatic cleaner and autoclave sterilization (DEC). For a fibrin clot, 9 mL of whole human blood and abutments was centrifuged at 2700 rpm for 12 min. Clots were divided into two parts for histomorphometry and scanning electron microscopy (SEM) analysis. Twelve abutments disconnected from the clot and two not treated with blood were observed under SEM.

Residual debris and biofilm were observed on the abutment surface in the CO group but not in other groups. Healthy and organized fibrin clots formed on all abutments. The fibrin extension areas are distributed uniformly in BN and DEC groups but irregularly in CO. The surface percentage of the fibrin clot extensions was 41.76% ± 6.73, 26.99% ± 6.40, and 37.83% ± 9.72 for the BN, CON, and DEC groups, respectively. The blood clot-attached areas in the CO group were statistically lower than the other groups. No difference was observed between the BN and DEC groups.

This study confirmed that surface contamination could influence blood clot attachment on the abutment surfaces. Cleaning and sterilization can have a favorable effect on soft tissue healing on abutment surfaces.