Various Surface Treatments to Implant Provisional Restorations and Their Effect on Epithelial Cell Adhesion: A Comparative In Vitro Study.

PURPOSE AND OBJECTIVE: The aim of this in vitro study was to investigate the ability of epithelial cells to attach to or proliferate on various mechanical or chemical surface treatments of an implant provisional material.

MATERIALS AND METHODS: Polyethyl methacrylate discs 10 mm in diameter and ∼0.2 to 0.75 mm in width were used in the study. Experimental discs were treated with either a mechanical (pumice, varnish for shine, or high polishing) or a chemical agent (alcohol, chlorhexidine, or steam) to provide cleaning and/or polishing. Using primary human epidermal keratinocytes, experiments were performed to test the adhesion or proliferation of cells on the discs with various surface treatments.

RESULTS: Scanning electron microscope analysis, rhodamine staining, and cell counting using a hemocytometer corroborated all findings and illustrated that the highest cell adhesion was found to be in the smooth surface treatment groups and the poorest adhesion was found to be in the rough surface groups and chemical treatment group.

CONCLUSION: Within the limitations of this study, the following clinical protocol is recommended for finishing, polishing, and disinfecting implant provisional restorations: coarse, medium, fine pumice → high polishing (if desired) → steam. It is recommended to avoid applying varnish in the perimucosal area near the epithelium. This study could establish the most appropriate way to handle provisional restorations in the peri-implant sulcus for improved soft tissue health, esthetics, and long-term stability.