Effect of Sealing Gel on Bacterial Microleakage at Implant-abutment Junction: A Split-mouth Randomised Controlled Trial

Abstract

Introduction: Dental implants are widely used for tooth replacement; however, challenges such as bacterial microleakage at the Implant-abutment Interface (IAI) can lead to complications. Sealing gels have been developed to close this gap and prevent issues like screw loosening and bacterial infiltration, thereby improving implant success. Aim: To compare bacterial microleakage at the Implant-abutment Junction (IAJ) with and without the use of sealing gel (conventional method). Materials and Methods: This Split-mouth randomised controlled study included 30 implant patients who visited the Department of Prosthodontics and the Department of Microbiology at Rural Dental College and Rural Medical College, Pravara Institute of Medical Sciences (Deemed to be University), Ahmednagar, Maharashtra, India, from April 2023 to October 2023. Based on inclusion and exclusion criteria, randomisation was performed using a lottery method, assigning 15 implant samples to each group. Before collecting saline samples, a sterile field assessment was conducted. The sealing gel was injected into the internal compartment of the implant, and a healing abutment was placed in Group A (medical-grade silicone was used as the sealing gel). In Group B, the healing abutment was placed without sealing gel at the IAI. The healing abutment was removed after 15-20 days, and 10 μL of sterile saline was introduced into the internal compartment of the implant using an insulin syringe. The saline was then drawn back up and transferred to the laboratory for microbial assessment to calculate the colony types and the number of colony counts using Colony-forming Units (CFUs). Statistical analysis was performed using the Chi-square test and the Mann-Whitney’s U test. Results: The mean age of the implant patients was 35±1 years, ranging from 20 to 50 years. Bacterial microleakage assessment showed that Group A (with sealing gel) had 100% sterility, while Group B (without sealing gel) exhibited only 4 (26.67%) sterile samples, 7 (46.66%) with Enterococcus growth, and 4 (26.67%) with Gram-positive bacilli growth in terms of colony types. The sterility in the number of colonies corresponded with the types of colonies for both groups. In Group B, there were 250 colonies in 3 (20%) of the samples, 500 colonies in another 3 (20%), and over 1000 colonies in 2 (13.33%) of the samples. There was a statistically significant difference in the number of sterile samples between the groups (p0.05). Conclusion: The use of sealing gel significantly reduces bacterial microleakage at the IAI, thus improving biomechanics and extending implant longevity for better oral health outcomes.

Keywords

• bacteria flora
• dental implants
• implant-abutment interface
• silicone gel