Implant Cement Tips and Info

1.Failure to completely remove excess cement can lead to future problems such as Peri-implantitis.

How is this combated?

There are several things that may be done to combat this.

- A screw retained crown eliminates the need for cement entirely

• Do not overload your crown with cement. The crowns are designed to fit snug against the implant not leaving much of a void for excess cement to fill. A sufficient ring around the inside at the gingival, allowing room for the cement to flow upwards, will lessen any excess flowing out.
• Make sure your abutment margin is not too far subgingival, allowing a probe to access any excess cement. 1 mm is sufficient on posterior crowns and 2 mm on anterior crowns. This will account for any tissue loss that may be associated with an implant.
• Use a zinc based cement. This cement is radio-opaque therefore any excess will be seen on an X-ray.

2. Many Dr.’s will use a temporary cement for a long term solution with the idea that, should the abutment, or screw, ever come loose, there is an accessibility to the screw to remove the abutment, and/or re-torque.

• There is nothing wrong with using a permanent cement on an implant crown. However, it should be noted that should the abutment ever need any tightening, or removal (Which, I would preface, is rare), the crown will most likely need to be destroyed to gain access to the screw.
• Some Dr’s will request the following as an added step to assure retention when using a temporary cement:

1.  Grit blasted abutment surface.
2. Drill 1 or 2 small hole at the apex of the abutment for reverse flow of cement into the chamber.
3.  Request “foiled” occlusion to ensure a light centric contact and no excursive movement contact.

There is a great study titled “A descriptive study of the radiographic density of implant restorative cements” by Wadhwani, et.al that goes into detail about name brand cements. I have many copies, and if you are interested, please contact me and I will send you one.