Updates for Dentists
At our most recent Dental Hygiene Study Club meeting, we discussed the problem of excess cement on dental implants. Multiple studies, as well as our own observations, indicate that excess cement is the primary cause of peri-implant gingival inflammation. We would like to offer some suggestions to help minimize this problem.
- Avoid deep interproximal margins. Use an anatomic abutment, such as Encode or a custom abutment. The deeper the crown margin, the more difficult it is to remove excess cement, and the more difficult it will be to maintain.
- Eliminate cement. Consider using a screw-retained crown/abutment, i.e. UCLA.
- Use a minimal amount of cement. Disperse the cement within the crown and squeeze out the excess cement by placing the crown on an analog (with the cement in the crown) immediately prior to seating it on the abutment in the patient’s mouth.
- Clean off the excess cement with a metal instrument. Plastic scalers will not adequately remove cement. A small scratch is less harmful than excess cement. Titanium curettes are the first choice. If necessary, use a stainless steel curette.
- Use Temp-Bond, polycaboxylate or zinc oxyphosphate cement. These are easier to remove and kinder to the tissue than glass ionomer cement.
- Treat inflammation around implants aggressively.
- We offer a no-charge post-restoration appointment to assess the health of every dental implant we place.
Thank you for your continued confidence and support.
John A. Bierly, DMD, Peter J. M. Peterson, DMD, and Jesse M. Sorrentino, DDS