Retained Cement

Retained cement has been indicated in a large number of peri-implant disease cases. Many dental implant cements are radiolucent and residual cement may not be detected radiographically, particularly if present on the buccal and/or lingual of the fixture. Residual cement may be rough and allow bacterial attachment and, subsequently, peri-implant inflammation.79 Prosthesis design in combination with the additional irritant of subgingival cement may promote incomplete plaque removal due to the creation of non-cleansable sites.80 Peri-implant disease prevalence is significantly higher at fixtures with cement-retained versus screw-retained restorations79,81 and in a case-control study, within a group of implants with diagnosed peri-implantitis, 81% had excess cement present compared to no retained cement found at healthy, control implants.82 Due to excess cement being a possible risk factor for peri-implant disease, it may be advisable to use screw-retained restorations when possible, practice techniques to avoid excess cement, allow for adequate soft tissue healing prior to seating of a permanent restoration, and allow for early follow up after initial restorative cementation to detect any early signs of cement retention.