A Systematic Review of Cementation Techniques to Minimize Cement Excess in Cement-Retained Implant Restorations

Abstract

Background: The most used types of retention of implant-supported prostheses are screw-retained or cement-retained restorations. The advantages and disadvantages of both have been identified by various authors over the years. However, cement-retained implant crowns and fixed partial dentures are among the most used types of restorations in implant prostheses, due to their aesthetic and clinical advantages. When cemented prostheses are made on implants, the problem of cement residues is important and often associated with biological implant pathologies. The objective of this research was to establish to what extent the techniques to reduce excess cement really affect the volume of cement residues. Materials and Methods: This review was written following the PRISMA statement; a detailed search was carried out in three different electronic databases—PubMed, Scopus, and Cochrane Library. The inclusion criteria were prospective clinical studies, with at least 10 participants per group, and with at least 6 months of the follow-up period. Results: There have been many proposals for techniques supposed to reduce the amount of excess cement in the peri-implant sulcus and on the prosthetic components, but of these, which are exceptional in their in vitro capabilities, very few have been clinically validated, and this represents the real limitation and a great lack of knowledge regarding this topic. Three articles met the inclusion criteria, which were analyzed and compared, to obtain the information necessary for the purposes of the systematic review. Discussion: Extraoral cementation can reduce the excess cement, which, after a normal excess removal procedure, is, nevertheless, of such size that it does not affect the possibility of peri-implant pathologies developing. All these studies concluded that a small amount of cement residue is found in the gingival sulcus, and using eugenol-free oxide cements, the residues were only deposited on the metal surfaces, with a better peri-implant tissues health. Conclusion: Despite the limitations of this study, it was possible to carefully analyze these characteristics and obtain valuable suggestions for daily clinical practice. Resinous cements are considered, due to the free monomers present in them, toxic for the soft tissues. The provisional zinc-oxide cements, also eugenol-free, represent the ideal choice. The different grades of retentive forces provided by these cements do not seem to have clinical effects on the decementation of restorations.

Assessment of the Accuracy of Two Different Dynamic Navigation System Registration Methods for Dental Implant Placement in the Posterior Area: An In Vitro Study

“…Apart from the biological and microbiological factors, the accuracy of the implant position is essential when performing dental implant restoration, as improper implant site selection can increase the short- and long-term risks of postoperative complications [ 1 , 2 , 3 , 4 ]. As dynamic navigation system (DNS) approaches continue to be developed and refined, the accuracy of these methods has remained an area of active study.…”

Applications and Clinical Behavior of BioHPP in Prosthetic Dentistry: A Short Review

“…The possibility that this material has to adapt perfectly to the partially or completely digital workflow and radiation-free diagnostic examination allows for obtaining high levels of aesthetics, and for being able to propose a precise treatment plan for the patient [7][8][9][10][11]. The main solution for its clinical application to date is still represented by cementation, unless intermediate metal components are used that allow it to be screwed, avoiding the various problems of cementation, which, however, can follow traditional techniques without particular differences using adhesive cements, composites, zinc oxide without eugenol, and zinc oxide with eugenol, avoiding only glass ionomer and zinc phosphates cements [12,13].…”

The Effect of a 10-MDP-Based Dentin Adhesive as Alternative for Bonding to Implant Abutment Materials

“…Additionally, it can also be considered with a deeper prosthetic finish line that allows the removal of excess cement. However, it has been demonstrated that extraoral cementation significantly decreases the amount of cement excess [ 4 ]. Many surface treatments, such as sandblasting, silicatization, plasma spraying, primer application, and laser etching [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ], have been suggested to achieve higher bond strength between resin cement and dental ceramics for dental-supported restorations.…”