Predictors of excess cement and tissue response to fixed implant-supported dentures after cementation

Abstract

Background: The cementation of fixed implant-supported restorations involves the risk of excess cement remaining in the peri-implant tissue that may cause a peri-implant tissue response with attachment loss. Purpose: The aim was to study the peri-implant tissue response after cementation and to detect potential predictors of excess cement. Material and Methods: Clinical complications after cementation in several index cases led to a recall of all patients treated with a special methacrylate cement (one hundred five patients with one hundred eighty-eight implants) and systematic reevaluation of 71 patients (68%) with one hundred twenty-six implants (67%). In all cases, suprastructures including abutments were removed, and findings were documented. Results: Implant diameter was significantly associated with the frequency of excess cement. Implant location or system had no significant effect. Excess cement in turn was associated with bleeding on probing, suppuration, and peri-implant attachment loss. In the absence of excess cement 58.8% of implants had no peri-implant attachment loss versus 37.3% when excess cement was present. With increasing retention time of the methacrylate cement, more peri-implant attachment loss was detected. However, the latter association was not significant. Conclusion: Larger diameters are significantly associated with excess cement in peri-implant tissue. Consequences of excess cement may be increased bleeding on probing, suppuration, and possibly peri-implant attachment loss.