Statement of problem
Complete removal of excess cement from subgingival margins after cementation of implant-supported
restorations has been shown to be unpredictable. Remaining cement has been shown to
be associated with periimplant inflammation and bleeding.
Purpose
The purpose of this study was to investigate and compare the amount of excess cement
after cementation with 4 different methods of cement application for cement-retained
implant-supported restorations.
Material and methods
Ten implant replicas/abutments (3i) were embedded in acrylic resin blocks. Forty complete
veneer crowns (CVCs) were fabricated by waxing onto the corresponding plastic waxing
sleeves. The wax patterns were cast and the crowns were cemented to the implant replicas
with either an interim (Temp Bond) or a definitive luting agent (FujiCEM). Four methods
of cement application were used for cementation: Group IM-Cement applied on the internal
marginal area of the crown only; Group AH-Cement applied on the apical half of the
axial walls of the crown; Group AA-Cement applied to all axial walls of the interior
surface of the crown, excluding the occlusal surface; and Group PI-Crown filled with
cement then seated on a putty index formed to the internal configuration of the restoration
(cementation device) (n=10). Cement on the external surfaces was removed before seating
the restoration. Cement layers were applied on each crown, after which the crown was
seated under constant load (80 N) for 10 minutes. The excess cement from each specimen
was collected and measured. One operator performed all the procedures. Results for
the groups were compared, with 1 and 2-way ANOVA and the Tukey multiple range test
(α=.05).
Results
No significant difference in the amount of excess/used cement was observed between
the 2 different types of cements (P=.1). Group PI showed the least amount of excess cement in comparison to other test
groups (P=.031). No significant difference was found in the amount of excess cement among groups
MI, AH, and AA. Group AA showed the highest amount of excess cement. The volume of
cement used for group PI specimens was significantly higher than for those in the
other groups (P=.001). With respect to the volume of cement loaded into the test crowns no statistically
significant difference was observed among other test groups (groups IM, AH, and AA).
Group MI used the least amount of cement, followed by group AH and AA. No correlation
between the amount of used cement and the amount of excess cement was found in any
of the tested groups.
Conclusions
Within the limitations of this in vitro study, the least amount of excess cement was
present when a cementation device was used to displace the excess cement before seating
the crown on the abutment (Group PI). With this technique a uniform layer of the luting
agent is distributed over the internal surface of the crown leaving minimal excess
cement when the restoration is seated.
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© 2013 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
