Why are SmartPegs single patient use only?
To avoid damage to the implant, the SmartPeg material is quite soft, which limits the lifetime of the threads
Osstell SmartPegs are delicate measurement devices. The Osstell instrument vibrates the SmartPeg through magnetic pulses and measures the resonance frequency of it. In order for the SmartPeg to function properly, it needs a firm attachment to the implant or abutment. Always check that the right SmartPeg Type is used. If there is resistance when mounting a SmartPeg, never use excessive force to screw it in – that could damage the SmartPeg. If the SmartPeg threads are damaged, it is possible that the SmartPeg will not function and give false ISQ-readings.
The SmartPegs are made from a soft metal with a zinc-coated magnet mounted on top of it. The SmartPegs will therefore rapidly wear after being opened. For this reason, and for hygienic reasons, the SmartPegs are disposable. The sterile package that holds the SmartPeg will hold sterility at least 5 years. The expiry date is stamped on the SmartPeg blister. During this time, it is possible that some areas on the SmartPeg will shift in color. For instance, there could be small visible spots on the SmartPeg body. These spots are an oxide and will not affect the function or sterility of the SmartPeg in any way.
Used SmartPegs should be recycled as metal.
The SmartPeg is made from soft aluminum. It must be much softer than the implant itself not to have any risk of damaging the implant and its connection. The wear and tear of aluminum is fast and visible after only a few inserts. The Osstell instrument will not provide accurate ISQ values if the connection with the implant is not 100%. Even very small changes will make a difference.
Autoclaving is thought to speed up the wear and tear, but also the corrosion of the aluminum because of the rather extreme conditions during the autoclaving process.
As the SmartPeg wears out, aluminum is “shaved off” in small tiny fragments – these will stay in the implant and its connection. What long term effects do they have? And what is the impact of the connection between the implant and the abutment? Most clinicians would try to avoid such situations, in any way they can. In our case: use a fresh SmartPeg.
Since the data integrity cannot be guaranteed after repeated use and/or autoclaving, the method is only approved for use with new SmartPegs.
There are of course other sterilization methods (cold), but they are not 100% in terms of sterilization, and the question of the mechanical wear and tear still remains.
General hygienic standards would suggest that you want to avoid reusing material that have been exposed to biological tissue etc earlier. That is the direction of most healthcare is being developed, and the same in dentistry.
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