Effect of abutment design and methods for controlling on the amount of residual luting agent around the margins of implant restorations

Year 2023, Volume: 9 Issue: 3, 45 - 52, 01.12.2023

İrem Karagözoğlu

Abstract

Objectives: The aim of this study was to investigate the amount of excess cement after cementation using three different cement application methods and to compare the effect of two different abutment designs on the residual cement in cement-retained implant restorations.
Material and methods: A maxillary cast was used to simulate implant placement in the lateral incisor region. Implant analogs were embedded in the maxillary cast. Right lateral custom abutment was designed non anatomically and left lateral custom abutment was designed anatomically with computer-aided design. After the screw channels were closed, a total of 80 monolithic translucent zirconia crowns were fabricated. Crowns were cemented with 3 different cementation techniques and without any technique in the control group. The amount of residual cement measured by computerised planimetric cement evaluation method.
Results: The lowest residual cement area was observed in the anatomic-teflon group, and the highest residual cement area was observed in the non-anatomic control group. In anatomic abutment design group, there was no significant difference between the control and rubber dam group (p > 0.05), but significant difference was found between control and other groups (p < 0.05). In non-anatomic group, statistically significant differences were found between the control and other groups (p < 0.05).
Conclusions: The anatomic abutment design significantly reduced the amount of residual cement compared to the non-anatomic abutment design. It was concluded that PVS replica technique was the most effective cementation technique in terms of residual cement.

Keywords

Abutment design, cement-retained restorations, excess cement, residual cement

References

• Wilson TG Jr. The positive relationship between excess cement and peri-implant disease: a prospective clinical endoscopic study. J Periodontol. 2009 Sep;80(9):1388-92. doi: 10.1902/jop.2009.090115. PMID: 19722787.
• Berglundh T, Armitage G, Araujo MG, Avila-Ortiz G, Blanco J, Camargo PM, Chen S, Cochran D, Derks J, Figuero E, Hämmerle CHF, Heitz-Mayfield LJA, Huynh-Ba G, Iacono V, Koo KT, Lambert F, McCauley L, Quirynen M, Renvert S, Salvi GE, Schwarz F, Tarnow D, Tomasi C, Wang HL, Zitzmann N. Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol. 2018 Jun;45 Suppl 20: S286-S291. doi: 10.1111/jcpe.12957. PMID: 29926491.
• Bhushan P, Aras MA, Chitre V, Mysore AR, Daswani SR. A Novel Universal Cementation Technique for Implant-Supported Crowns with Subgingival Margins. Journal of prosthodontics: official journal of the American College of Prosthodontists. 2017;26(7):628-32.
• Rayyan MM, Makarem HA. A modified technique for preventing excess cement around implant supported restoration margins. The Journal of prosthetic dentistry. 2016;116(6):840-2.
• Lee JH, Park IS, Sohn DS. A digital approach to fabricating an abutment replica to control cement volume in a cement-retained implant prosthesis. The Journal of prosthetic dentistry. 2016;116(1):25-8.
• Hess TA. A technique to eliminate subgingival cement adhesion to implant abutments by using polytetrafluoroethylene tape. The Journal of prosthetic dentistry. 2014;112(2):365-8.
• Linkevicius T, Vindasiute E, Puisys A, Peciuliene V. The influence of margin location on the amount of undetected cement excess after delivery of cement- retained implant restorations. Clin Oral Implants Res. 2011;22(12):1379-84.
• Present S, Levine RA. Techniques to control or avoid cement around implant- retained restorations. Compendium of continuing education in dentistry (Jamesburg, NJ:1995). 2013;34(6):432-7.
• Linkevicius, T., Vindasiute, E., Puisys, A., Linkevi- ciene, L., Maslova, N. & Puriene, A. The influence of the cementation margin position on the amount of undetected cement. A prospective clinical study. Clinical Oral Implants Research 2013; 24(1): 71–76.
• Wadhwani C, Pineyro A. Technique for controlling the cement for an implant crown. J Prosthet Dent. 2009;102(1):57-8.
• Patel D, Invest JC, Tredwin CJ, Setchell DJ, Moles DR. An analysis of the effect of a vent hole on excess cement expressed at the crown-abutment margin for cement-retained implant crowns. Journal of prosthodontics : official journal of the American College of Prosthodontists. 2009;18(1):54-9.
• Ishikiriama A, Oliveira Jde F, Vieira DF, Mondelli J. Influence of some factors on the fit of cemented crowns. J Prosthet Dent. 1981;45(4):400-4.
• Salem D, Alshihri A, Levin L. Peri-implantitis induced by a retained retraction cord. Quintessence International. 2014;45(2).
• Chee WW, Duncan J, Afshar M, Moshaverinia A. Evaluation of the amount of excess cement around the margins of cement-retained dental implant restorations: the effect of the cement application method. J Prosthet Dent 2013;109:216-21.
• Bukhari SA, AlHelal A, Kattadiyil MT, Wadhwani CPK, Taleb A, Dehom S. An in vitro investigation comparing methods of minimizing excess luting agent for cement-retained implant-supported fixed partial dentures. J Prosthet Dent. 2020 Dec;124(6):706-715. doi: 10.1016/j.prosdent.2019.11.016. Epub 2020 Jan 24. PMID: 31987589.
• Kappel S, Eiffler C, Lorenzo-Bermejo J, Stober T, Rammelsberg P. Undetected residual cement on standard or individualized all-ceramic abutments with cemented zirconia single crowns - a prospective randomized pilot trial. Clin Oral Implants Res. 2016;27(9):1065-71.
• Agar JR, Cameron SM, Hughbanks JC, Parker MH. Cement removal from restorations luted to titanium abutments with simulated subgingival margins. J Prosthetic Dent. 1997;78:43–7.
• Priest G. Virtual-designed and computer-milled implant abutments. J Oral Maxillofac Surg. 2005;63(Suppl 2):22–32.
• Sancho-Puchades M, Crameri D, Özcan M, Sailer I, Jung R, Hämmerle C, et al. The influence of the emergence profile on the amount of undetected cement excess after delivery of cement-retained implant reconstructions. Clinical oral implants research. 2017;28(12):1515-22.
• Wasiluk G, Chomik E, Gehrke P, Pietruska M, Skurska A, Pietruski J. Incidence of undetected cement on CAD/CAM monolithic zirconia crowns and customized CAD/CAM implant abutments. A prospective case series. Clinical oral implants research. 2017;28(7):774-8. 52
• Agar JR, Cameron SM, Hughbanks JC, Parker MH. Cement removal from restorations luted to titanium abutments with simulated subgingival margins. J Prosthet Dent. 1997;78(1):43-7.