Odor when healing cap or abutment removed: what do you do?

Last Updated: May 12, 2016

I am sure we have all had this same experience: you remove a cover screw, healing cap or temporary abutment and notice a foul odor coming out of the implant screw hole. Sometimes even the patient will comment about it. Often the retaining screw will have blood on it. I have noticed this in delayed loading cases as well. I have always simply restored these cases with no apparent ill effects. I have attributed this to necrotic cellular debris and anaerobes down in that little hole. My question to all out there is this: do any of you irrigate the implant screw hole before placing the final abutment? If so, why? What is your protocol? I have never seen this discussed or read any literature on the subject. Should we even care?

10 Comments on Odor when healing cap or abutment removed: what do you do?

Comments Closed

New comments are currently closed for this post.

Suhas Vaze

05/17/2016

I always irrigate with N S. It becomes clean and there is no harm. It is inexpensive as well.

Ed DErgosits

05/18/2016

Normal saline is good but why not irrigate with an antibacterial like chorhexidene or benzalkonium chloride with additional sonic agitation?

Jacques Benizri

05/17/2016

I place the tip of my air polisher and I rinse with sodium bicarbonate 3 seconds and it's done and clean.

Alejandro Berg

05/17/2016

We usually use metronidazol (a 1cc vial) and irrigate inside the impant.... cheers

Alejandro Berg

05/17/2016

sorry I forgot, for those of us that are old enough to remember, there was a time when we placed neosporin gel or ofthalmic ab on the thread of the primary cap during initial surgery to avoid this smell.... just a reminder of old times ( this had no statistic influence on the survival of the implants)

Nick Southall DMD

05/17/2016

I generally don't see this with platform switch, conical connection.

natalino guarasci

05/18/2016

I agree with you:conometric connections (Morse cone) don't permit any bacterial colonization of the implant/abutment connection..imagine the longstanding adversal effects of this colonization against crestal bone on the definitive abutments and restorations!

John Seward

05/18/2016

We use ozonated water to clean out, works a treat!

Jalil Sadr, DMD, MSD

05/20/2016

I use chorhexidene always, no harm with it. it makes you feel sure and better. Also, I have patient to resins with it before removing screw. we clean disinfected the screw for later on use.

Jacob Froerer

05/23/2016

Great heads up! With the ease of use with Chlorhexidine, I will ensure a good dental implant outcome for my patients.

« what to do next what size of implant wider narrow 0918 »