- Use radiopaque Temp-bond, Temp-bond NE, or zinc phosphate cement (Zn inhibits bacterial growth).
- Use a custom abutment and not a stock abutment (this brings the cement line closer to the margin).
- Use less cement.
- Place a vent hole in the abutment (or instruct your lab do this).
- Place gutta percha, cotton, or teflon tape in occlusal access opening (but leave space for excess cement).
- Seat crown on an abutment replica to remove excess cement prior to inserting in the mouth.
- Do not use Resin modified glass ionomer cement (it is the most commonly used final cement, but it is radiolucent and difficult to remove in a deep sulcus).
- Do not use Durelon (it will corrode titanium).
- Do not use tissue colored cements.
- Understand that most cements were tested to inhibit caries forming bacteria (not periodontal pathogens which are commonly found associated with implant failures and excess cement).
- Understand the different biology of attachment of gingival tissues to a tooth versus an implant (there is not a strong intact compartment of tissue fibers to stop peri-implant disease penetration once it starts).
- Recommend having your hygienists pay close attention to the gingiva around implant restorations.
Feedback? Questions? Please feel free to post a comment below.
Joseph Pechter, DMD, Peridontist and Dental Implant Surgeon
Implant Cementation - Clinical Problems and Solutions
The Role of Dental Cements on Implant Success - Part 1
The Role of Dental Cements on Implant Success - Part 2
Technique for Controlling the Cement for an Implant Crown
Techniques to Control or Avoid Cement around Implant-Retained Restorations