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Clin Implant Dent Relat Res. 2015 Aug;17(4):771-8. doi: 10.1111/cid.12170. Epub 2013 Nov 14.

Clinical Factors Influencing Removal of the Cement Excess in Implant-Supported Restorations.

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Vilnius Research Group, Vilnius, Lithuania.
Vilnius Implantology Center, Vilnius, Lithuania.
Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.



The depth of the cementation margin has an influence on the amount of cement remnants around implants. However, the role of other clinical factors is still not clarified.


The aim of the study was to evaluate the correlation between undetected cement and (i) location of the implant, (ii) implant diameter, and (iii) undercut.


Sixty-five patients were treated with single metal-ceramic restorations on implants. The undercut between the restoration and the tissue was measured. After cementation, the restoration-abutment unit was unscrewed. All quadrants of the specimens were photographed and analyzed. The ratio between total restoration area/peri-implant tissue area and area of cement remnants was calculated in pixels. Significance was set to 0.05.


Sixty-five metal-ceramic restorations were placed on 65 implants (39 molars, 22 premolars, 4 anteriors; 21 implants had a diameter of 3.5 mm, 34 of 4.0 mm, 10 of 5.0 mm). An undercut of 1 mm was found in 118 sites, 2 mm in 96 sites, and 3 mm in 46. The percentages of soft tissue and restoration, respectively, covered by cement were as follows: molars 4% and 7%; premolars 3.8% and 7.3%; anteriors 3% and 3.4%; 3.5 mm diameter 3.3% and 7.4%; 4.0 mm 7.7% and 7.7%; 5.0 mm 3.9% and 2.1%; 1-mm undercut 3.5% and 5.4%; 2-mm 4% and 8.1%; 3-mm 4.8% and 8.4%. The relationship between amount of cement remnants and implant location was insignificant (p > 0.05) for both soft tissue and the specimen, but significant relationships with amount of cement remnants were found for diameter (p = 0.026 for soft tissue, p = 0.600 for specimen) and undercut (p = 0.004 for soft tissue, p = 0.046 for specimen).


If cemented crown restoration is desired, undercuts should be reduced to a minimum for better removal of cement excess, irrespective of the diameter and location of the implants in the mouth.


cement cleaning; cement excess; cement-related peri-implantitis; cement-retained implant restorations; implant diameter; undercut

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