Abutment margin levels and residual cement occurrence in cement‐retained implant restorations: An observational study

Abstract

Objectives:To evaluate the association between different vertical levels of the abutment margin and residual cement prevalence in cement-retained implant restorations with customized abutments. Methods:One hundred and nine single-unit cement-retained implant restorations with a screw-access channel were included. The crowns were intraorally cemented on the abutments, and excess cement was removed. The abutment-crown complex was unscrewed, and the abutment-crown complex and peri-implant tissue were photographed. Residual cement presence was recorded by dividing the abutment-crown complex and peri-implant tissue into four quadrants: mesial, distal, buccal, and lingual.The prevalence of residual cement was compared according to the height of the custom abutment margin of the corresponding quadrant. A multilevel model was used for statistical analysis (α = .05).Results: Cement remnants were discovered on 72.48% of the dental implants. When the restoration quadrants were compared, cement remnants were present on 51.38%, 39.45%, 20.18%, and 17.43% of the mesial, distal, buccal, and lingual surfaces, respectively (p < .01). Regarding the abutment margin level, cement residues were found in 60.22% and 61.4% of the 0.5 mm subgingival and ≥1 mm subgingival margin groups, respectively, which were significantly more than those in the supragingival (23.65%) and equigingival (26.59%) margin groups (p < .01). After adjustment for confounding factors, the adjusted odds ratio (with 95% confidence interval) for residual cement in the subgingival margin groups was 3.664 (1.71, 7.852) when compared to the supragingival and equigingival margin groups. Conclusions:The risk of residual cement occurrence was 3.66-fold higher with a subgingival abutment margin than with supragingival and equigingival abutment margins.

A Mapping Review of the Pathogenesis of Peri-Implantitis: The Biofilm-Mediated Inflammation and Bone Dysregulation (BIND) Hypothesis

“…Other prosthetic elements associated with increased risk include the restorative contour and emergence angle [87,88], mucosal emergence angle [89], sulcus depth [90], and the position of the restoration margin relative to the crestal bone [91]. Studies also indicate that deeper crown cementation margins and concave abutments are associated with a greater quantity of excess cement [92][93][94], and this could also increase the risk for peri-implant diseases [95]. Prosthetic factors influencing biofilm control may be implant site specific, leading to different microbiological stable states in the same individual.…”