Excess Cement Research Articles

Precisión de las radiografías digitales bitewing con y sin aplicación de desplazamiento horizontal del tubo en el diagnóstico del exceso de cemento residual alrededor de los implantes dentales: Un estudio in vitro

Purpose: This study was designed to evaluate the diagnostic value of digital Bitewing (BW) radiographs with and without horizontal tube shift in detecting Residual excess cement (REC) on the proximal and non-proximal surfaces of implant restorations. Material and Methods: Eight mandibular models were fabricated with two implants placed on each side in the premolar and first molar positions. Excess cement was applied to either proximal or non-proximal surfaces of the restorations intentionally during the process of crown cementation. BW radiographs with and without applying horizontal tube shift were acquired. Three maxillofacial radiologists were asked to determine the presence and location of REC in the radiographs. Sensitivity and specificity of the radiographic technique were assessed according to the restoration surface that contained REC. Results: Sensitivity of BW radiographs was 100% for the detection of REC on the proximal surfaces and 41-18, 80% on the non-proximal surfaces. Specificity of the technique was 85.71%-100% for the proximal surfaces and 75-94. 12% for the non-proximal areas. Specificity of the radiographic method was generally greater than its sensitivity for the non-proximal surfaces while in the proximal areas, the two variables had quite similar values. Conclusion: Digital BW radiography is generally more useful for detection of REC on the proximal surfaces. Higher specificity of this technique for the bucco-lingual surfaces suggests more reliability of the negative diagnoses in the non-proximal areas.

The influence of two different cements on remaining cement excess in cement-retained implant-supported zirconia crowns. An in vitro study

AimTo compare the amount of remaining cement excess after cementation of implant-supported zirconia crowns with zinc phosphate or calcium aluminate glass ionomer cement.MATERIALS AND METHODSTwenty zirconia crowns were cemented on dental implant abutments using a calcium aluminate glass ionomer cement (n = 10) and zinc phosphate cement (n = 10). After removal of cement excess, remaining cement excess were measured with pixel area calculation method and by weighing. Differences in amount of remaining cement excess were analyzed using Independent Samples t-Test. Level of significance was set at p = 0.05.ResultsZinc phosphate cement had a significantly greater amount of remaining cement excess than calcium aluminate glass ionomer cement in terms of total number of pixels (p = 0.002) and amount in grams (p = 0.005).ConclusionThe study suggests that the amount of remaining cement excess can be affected by the type of cement. Calcium aluminate glass ionomer cement may be a more suitable choice for cement-retained dental implant restorations, and possibly reduce the risk of complications related to cement excess such as peri-implant disease. Further studies are needed to verify the results from the present study.

Creation of a Custom-Length, Humeral Antibiotic Cement Spacer for Use in Treatment of Shoulder Periprosthetic Joint Infection

Periprosthetic joint infection of the shoulder is a challenging clinical situation to manage owing to the fastidious organisms often present and delayed clinical presentation. While several treatment options have been described, the mainstay of treatment remains a staged revision with the use of a humeral antibiotic cement spacer. Such spacers are commercially available or can be made by hand. When an extended humeral osteotomy is required to remove a well-fixed long stem humeral component, it may be advantageous to place an antibiotic spacer with a stem length approximately as long as the hardware being removed. This technique demonstrates creation of a custom length, humeral antibiotic cement spacer for use in treatment of shoulder periprosthetic joint infection.

Screwed and cement implant prosthesis: current clinical considerations

ABSTRACT Introduction: There is no consensus as to which cemented or screwed retention system is best to avoid bone loss around the implant from a fixed implant-supported restoration. Objective: To evaluate the prosthesis retention systems on screw and cemented implants, regarding: bone loss, survival and failure rate, biological complications and microbiological analysis. Methods: A search was made for scientific articles that contemplated the subject through the databases Pubmed and SciELO, without period restriction. The titles, abstracts and then access to the full text has been verified. Results: It was found that excess cement may play an important role in the development of peri-implant disease. Technical failures are most seen in prosthesis retained by screws, and biological complications in cemented crowns. The success rate for both restraint systems is high, and retention-independent implant prosthesis treatment provides predictability. Conclusion: The appropriate retention system for the patient depends on several factors, including indication, advantages and disadvantages, retention provided, aesthetics and clinical performance.

Comparison of residual cement between CAD/CAM customized abutments and stock abutments via digital measurement in vitro

OBJECTIVE To compare the residual cement between computer aided design/computer aided manufacturing customized abutments (CCA) and stock abutments (SA), and to evaluate the feasibility of digital measurement for residual cement volume by three-dimensional scanning. METHODS Twenty master models needed in this study were all taken from one 47-year-old patient with arrested periodontitis, who had already had an implant placed at his right upper central incisor site in the Department of Periodonto-logy, Peking University School and Hospital of Stomatology. After 4 weeks of soft tissue conditioning by means of customized healing abutment, the height of peri-implant soft tissue was measured, from the implant platform to mucosal margin, as 5 mm. Using customized impression coping, the impression was taken and twenty models were fabricated and allocated to 4 groups according to the type of abutments: CCA1 (5 mm transmucosal height CCA, with margin at tissue level), CCA2 (4 mm transmucosal height CCA, with 1 mm submucosal margin), SA1 (3 mm transmucosal height SA, with 2 mm submucosal margin) and SA2 (1 mm transmucosal height SA, with 4 mm submucosal margin). Crowns were cemented to the abutments, which were seated on the working models. Excess cement was removed by a prosthodontic specialist. Thereafter, the volume of residual cement was evaluated by using three-dimensional scanning technique. The area proportion of residual cement was calculated on photographs taken by a single lens reflex camera. The weight of residual cement was weighed by an analytical balance. And the correlation of residual cement volume data with residual cement area proportion or weight of residual cement acquired by traditional methods was analyzed. RESULTS Residual cement was observed on all the experiment samples. The residual cement volume of CCA was significantly less than that of SA [(0.635 3±0.535 4) mm3vs. (2.293 8±0.943 8) mm3, P 0.75, P < 0.001). CONCLUSION These in vitro results suggest that CCA minimized the residual cement more effectively than SA. The method to digitally evaluate the residual cement volume is feasible, but its validity and reliability need to be further studied.

Secure and precise insertion of minimally invasive resin-bonded fixed dental prostheses after ridge augmentation by means of a positioning splint.

Single-retainer resin-bonded fixed dental prostheses (RBFDPs) are described as an excellent minimally invasive treatment modality for the replacement of a single missing incisor even in cases of congenitally missing teeth that are often associated with hard and soft tissue defects that need to be properly managed to optimize the esthetic outcome. The lack of a retentive form due to the minimally invasive preparation form makes the adhesive bonding procedure for RBFDPs relatively technique-sensitive and might discourage practitioners from offering this treatment modality. A patient with both maxillary lateral incisors congenitally missing was assessed for eligibility for treatment with RBFDPs. Bilateral horizontal ridge defects were present and treated through ridge augmentation to ensure an ovate pontic design and enhance the esthetic outcome. A minimally invasive preparation within enamel was conducted; the restorations were digitally designed and milled out of (3Y-TZP) zirconia ceramic with labial veneering with feldspathic ceramic for enhanced esthetics. An improved design of positioning splints was used for the adhesive bonding procedure to ensure exact, secure, and flawless insertion of the restorations. RBFDPs offer a highly esthetic treatment modality for missing teeth in the anterior area. Tissue defects could be overcome be means of a minor oral surgery, while using improved positioning splints might ensure flawless adhesive bonding and promote the usage of RBFDPs. Hard and soft tissue defects can be remarkably optimized through a minor ridge augmentation. Improved positioning splints allow an easy and secure positioning as well as visual inspection of the seating in end-position and complete removal of resin cement excess. Implementing the concept of insertion splints might promote RBFDPs for anterior tooth replacement as it helps preventing bonding errors.

Premature Failure of CPVC Drainpipes

Water leaks were noticed from a chlorinated polyvinyl chloride (CPVC) drainpipe system used in a cafeteria only 3 months after the commissioning of the building. The drainpipe was used to recover food waste using various systems installed directly in the kitchen. The leak was caused by the presence of numerous cracks in some of the elbows from the drainpipe system. Scanning electron microscopy showed the presence of mud cracking, which is generally associated with environmental stress cracking. Chemical analyses revealed the presence of incompatible products with the CPVC, coming from the chemical transformations in the composting process and from excess cement used to assemble the various sections of the drainpipe system.

An auxiliary device for screw-retained fixed implant restorations which prevents extrusion of cement into screw-access openings

For screw-retained fixed implant prostheses, the cement that extrudes onto the margin can be easily removed, but the cement that may intrude into the screw-access opening (SAO) during the extraoral bonding process is difficult to eliminate. This article presents a manufactured auxiliary device that is applied to the extraoral bonding process of screw-retained fixed implant prostheses. This device will prevent excess cement from being left in the SAO.

Comparison of excess cement around implant crown margins by using 3 extraoral cementation techniques

Statement of problemExtrusion of excess cement into the subgingival area around implant-supported crowns is associated with detrimental inflammatory response, but controlling this excess material remains a challenge. PurposeThe purpose of this in vitro study was to perform a comparative analysis of 3 extraoral cementation techniques to reduce excess extruded cementation material around implant-supported crowns. Material and methodsForty-four internal connection implant replicas were embedded in acrylic resin to form the experimental model. Cementable abutments were tightened onto the implants. Zirconia crowns were luted to each of the cementable abutments by using 1 of 4 techniques: control, pattern resin analog that was 3D-printed, fast-setting polyvinyl siloxane analog, and putty index analog. Extruded excess cement was collected at each luted crown and weighed. ResultsThe mean residual weight of excess cement found in the pattern resin analog technique group was the least (0.087 mg), followed by the polyvinyl siloxane analog technique group (1.678 mg). The putty index analog technique group reported the least reduction of excess extruded cement (7.621 mg). All techniques produced substantially less extruded cement than the control (85.166 mg). In a 1-way analysis of variance, statistically significant differences (P<.001) were found among all the test techniques. Pairwise comparisons also found that all 3 test techniques were statistically different from each other. ConclusionsThe pattern resin (3D-printed) analog technique produces the least amount of extruded excess cement at an implant-supported crown, limiting detrimental impact on peri-implant tissue health.

Applications to reduce the amount of excess cement for cement-retained implant supported prostheses: Mini review

Applications to reduce the amount of excess cement for cement-retained implant supported prostheses: Mini review

Cleaning Efficacy of Poly-ether-ether-ketone Tips in Eliminating Cement Remnants Around Implants With Different Abutment Heights.

The excess cement not removed after the cementation of fixed implant-supported restorations may cause loss of peri-implant attachment or adjacent bone. The aims of this study were to evaluate the amount of residual cement at different abutment-crown connection levels and to test the cleaning efficacy of poly-ether-ether-ketone (PEEK) ultrasonic tips after cementation. One implant was placed in an anterior central tooth position 5 mm below the gingival margin in an acrylic model, and 32 stone models were obtained with implant analogs. Abutment heights of 1-2 and 2.5-4 mm were used on the vestibular and lingual sides, respectively. Crowns were cemented and cleaned, and half of the samples were cleaned again using PEEK tips. The abutment-crown suprastructure was then disconnected, and cleaning efficacy was evaluated. Varying amounts of excess cement were found on all specimens except for the PEEK group with abutment-crown connections 1 mm below the gingival margin. An increase of undetected cement remnants was observed when the restoration margins were located deeper subgingivally. Various amounts of excess cement associated with margin location were detected on the abutment-restoration complex despite meticulous cleaning efforts. Ultrasonic PEEK tips were effective at cleaning the cement remnants around implants to a certain depth.

Advanced therapeutics for peri-implant problems

When bone loss is present around a dental implant, advanced diagnosis and treatment are necessary. Excess cement is a known cause of peri-implant disease and should be ruled out as a first step. If cement is present, it should be removed with a curette, not an ultrasonic scaler. The dental endoscope can aid the clinician with cement removal using a non-surgical approach. Occasionally, surgical access with a videoscope is necessary for cement removal and/or treatment of the implant surface. Surgical treatment that is not aimed at regeneration is similar to osseous surgery around natural teeth. This is a predicable approach but yields unaesthetic results. Regeneration of bone and re-osseointegration of the implant is unpredictable and the surgical methods used are controversial.

Peri implantitis: An overview

Biologic complications associated with dental implants primarily relate to infection in the soft and hard tissue around implants known as peri implant mucositis and peri implantitis respectively. Prevalence of peri implantitis rates upto 60% and lead to the loss of implants. Current evidence points to poor oral hygiene, history of periodontitis, and smoking as being the strongest risk indicators for peri implantitis along with the factors affecting plaque accumulation and removal like design of prosthesis and excess cement. Different methods are used to assess peri implant tissue health and to diagnose these entities. Various treatment modalities are available including conservative and surgical approaches for the treatment of peri implant diseases so as to achieve reosseointegration of the exposed implant surface, being the ultimate goal. The aim of this review is to provide an overview regarding etiology, diagnosis and treatment of peri implantitis. Keywords: Mouthwash, Chlorhexidine, Stains, Bacteria.

Undetected Excess Cement at Marginal Areas of Zirconia Crown Copings: In Vitro Analysis of Two Luting Agents and Their Influence on Retention.

To evaluate the amount of residual cement (ECL) around the margins of zirconia crown copings after careful luting and cleaning procedures and to investigate these factors in relation to two tested luting materials. An experimental model of a maxillary arch was selected for this in vitro study. The maxillary first molar was prepared to receive an all-ceramic, single, full-crown restoration with a finish line located 1 mm below the artificial gingiva. After scanning of the prepared tooth, 20 paired zirconia coping-abutment assemblies were CAD/CAM fabricated. A slot in the model allowed for insertion and removal of the assemblies for each new test. Specimens were divided into two groups according to the cementation procedure: half (n = 10) were luted using a resin-modified glass-ionomer (RMGI) (Ketac-Cem Plus) (GI group), and the other half with a dual-curing self-adhesive resin agent (RelyX Unicem 2) (UN group). The substructures were loaded with cement, and a customized preseating device was adopted for preliminary reduction of excess. The zirconia copings were finally seated on their respective abutments located on the simulation model. A blinded investigator attempted to remove all excess cement with clinically available instruments. The amount of excess cement left in situ after cleaning procedures was weighed in grams. Dislodging forces of luted coping-abutment assemblies were obtained by using pull-off tests in a universal testing machine (crosshead speed of 0.5 mm/minute) after 24 hours of water storage. Means and standard deviations were calculated for ECL and for retention force values, and Mann-Whitney and ANOVA tests were carried out to detect significant differences (α = .05) among groups. Cement remnants were found in all specimens despite the cleaning procedures, with a typical distribution in interproximal areas. Mean ECL values for the GI and UN groups were 0.0079 ± 0.0060 and 0.0107 ± 0.0081, respectively. No statistically significant differences were found between tested cements (P = .3284). Removal stress values (MPa) were significantly higher (P = .0313) for the UN group (12.4 ± 6.5) than for the GI group (6.57 ± 4.69). Similar amounts of undetected cement remnants were discovered around the esthetic margins of zirconia crown copings regardless of cement type. The luting procedure using the self-adhesive resin cement provided significantly higher early retention values than the RMGI material.

An in vitro investigation comparing methods of minimizing excess luting agent for cement-retained implant-supported fixed partial dentures

Statement of problemThe use of cement-retained implant-supported prostheses is a well-established treatment option. Techniques have been proposed to reduce the amount of residual excess cement (REC) around cement-retained single-implant restorations. However, studies evaluating the effectiveness of such techniques related to cement-retained implant-supported fixed partial dentures (CRISFPDs) are lacking. PurposeThe purpose of this in vitro study was to evaluate the effectiveness of various cement application techniques for CRISFPDs. Material and methodsTwo implant analogs were placed in the lateral incisor sites in a maxillary, 3D printed cast with 4 missing incisors. Twenty standardized, removable, printed soft-tissue replicas, 40 milled titanium custom abutments, and 20 milled zirconia CRISFPDs were fabricated. Two cement application techniques, the brush on technique (BOT), and the polyvinyl siloxane index (PI) technique were compared. Two cementation techniques, without bib (control) (n=10) and with a polytetrafluoroethylene (PTFE) bib (test) (n=10), were used. A premeasured amount of interim cement was used to cement the CRISFPDs. The CRISFPDs were retrieved after cementation, and standardized photographs of 4 quadrants of each abutment-CRISFPD assembly were made by using a software program that is used to calculate the ratio between the area covered with REC and the total specimen area. The extension of the REC on both the abutment and soft-tissue replica was measured at sites before and after cleaning the REC. A generalized linear mixed-model procedure was used for statistical analysis (α=.05). ResultsFor cement application, the polyvinyl siloxane (PVS) index technique had significantly less REC than the brush on technique (P<.05). The use of a PTFE bib led to significantly less REC than when no bib was used (P<.05). ConclusionsThe use of the PVS index technique along with a PTFE bib was effective in reducing REC for CRISFPDs.

Determination of Excess Removability of Self-Adhesive Resin Cements

Objective: This study aimed to determine the force required to remove a defined amount of self-adhesive resin cements excess from a (pretreated) dentin surface after tack curing. Methods: Bovine teeth (n=5) were ground flat to expose dentin, polished (grit 320 sandpaper), distilled water rinsed, and gently air-dried. With the aid of a drilling template fixed with superglue (Sekundenkleber, Renfert GmbH), 1 to 3 cylindrical cavities (4.5±0.1mm diameter x 2.0±0.1mm depth) were drilled. Superglue was mechanically removed after drilling. Resin cement weighing 30mg was placed in the cavity and pushed through with a stainless-steel rod (4.0±0.05mm diameter x 2.0±0.1mm height), so that all of the excess cement was pushed out onto one side of the cavity to form a half moon. Excess cement was cured for a defined time of 5 seconds, from a defined distance (2mm spacer) from the tooth surface using an EliparTM S10 light curing device (3M ESPE). Excess cement was sheared off using a jig (Zwick Z010, n=5; speed= 0.75mm/min). Maximum force (N) to shear off the excess cement was recorded. Results: Experimental Cement and Calibra® Universal were statistically lower in mean newton force than the other selfadhesive resin cements. TheraCem® Ca and RelyX™ Unicem 2 were not statically different from each other. Maxcem EliteTM Chroma and G-CEM LinkAce® were statistically lower than TheraCem® Ca and RelyX™ Unicem 2. Conclusion: A method was developed to quantify force needed to remove cement excess. Under standardized conditions, different levels of removal force were identified. PANAVIA™ SA Cement Plus, Calibra® Universal and Experimental Cement require a significantly lower force for excess removal. SpeedCEM® Plus and Maxcem EliteTM Chroma require an intermediate force. RelyX™ Unicem 2 and TheraCem® Ca require a significantly higher force to achieve excess removal. Excess removal force can be lowered by reducing irradiation time as shown with RelyX™ Unicem 2 (one second cure) and RelyX™ Unicem 2 (two second cure).

Vertical Marginal Discrepancy of Retrievable Cement/Screw-retained Design and Cement-retained Implant-supported Single Metal Copings

To compare the vertical marginal discrepancy of retrievable cement/screw-retained design (RCSRD) and cement-retained (CR) implant-supported single metal copings cemented on implant abutments. Single metal copings were fabricated for 20 4.5 × 10 mm titanium dental implants. Two groups of 10 implants each were randomly allocated. One group received RCSRD metal copings and the other group received CR metal copings. Both types of restorations were fabricated on solid abutments with 5.5 mm of diameter. The copings were cemented with resin cement. After the cementation procedure, cement excess was carefully removed in both groups. Inspections of coping-abutment vertical marginal discrepancy were measured using scanning electronic microscopy (SEM) under 800× magnification. The independent sample Student's t test was used to detect differences between groups (p < 0.05). The RCSRD implant-supported metal coping group (57.80 ± 2.34 μm) showed statistically better vertical marginal discrepancy than the CR implant-supported metal coping group (64.40 ± 2.23 μm) (p = 0.001). The RCSRD implant-supported metal copings offer less vertical marginal discrepancy than the CR copings group. This new technique would decrease the marginal discrepancy with less bacterial filtration and biomechanical problems. Retrievable cement/screw-retained design is another alternative technique for dental implant rehabilitation that combines the advantages of CR and SR prostheses. The hybrid design offers less vertical marginal discrepancy for better control of bacterial filtration and biomechanical problems.

Patellar Bone-Grafting for Severe Patellar Bone Loss During Revision Total Knee Arthroplasty

Treatment of severe patellar bone loss during revision total knee arthroplasty (TKA) is difficult. Patellar bone-grafting is a simple procedure that can improve patient outcomes following revision TKA. The patient is prepared and draped in the usual sterile fashion. The previous longitudinal knee incision is utilized for exposure. Scar tissue is excised from the medial gutter. However, tissue in the lateral gutter is largely maintained. An assessment of the surrounding quadriceps and patellar scar tissue ensues. This tissue can be utilized to create an envelope for holding the bone graft in place. If insufficient tissue is present, fascia from the iliotibial band or vastus medialis, allograft fascia, or synthetics can be used.A careful assessment of component fixation and rotation is critical to the success of patellar bone-grafting. Component revision for aseptic loosening or malrotation should be performed in the usual fashion. During component revision, it is recommended to preserve any additional bone as autograft for the patellar bone-grafting procedure. Common sites of autograft harvest include the femoral box cut and proximal tibial resection.The patella is then addressed by carefully removing the previous implant to avoid additional bone loss. This step is performed with a combination of an oscillating saw, osteotomes, and high-speed burr. The retropatellar bone is then prepared by debriding excess soft tissue, cysts, or cement. A high-speed burr is then utilized to produce a punctate bleeding surface for bone-graft incorporation.The harvested tissue is closed around the perimeter of the patella with use of interrupted nonabsorbable sutures, leaving a window to pack in the bone graft. The bone graft (allograft and autograft) is morselized and place through the window.The optimal patellar thickness is variable. After packing the bone graft through the soft-tissue window, the thickness is measured with a caliper. It is recommended to acquire a thickness of >20 mm because bone-graft resorption and remodeling occur with knee range of motion. The remaining soft-tissue window is closed with use of nonabsorbable sutures. The knee is cycled through a range of motion to ensure optimal patellofemoral tracking. If necessary, a lateral release or medial soft-tissue advancement can be performed to ensure patellofemoral tracking is adequate. Finally, the wound is irrigated and closed in layers. Nonsurgical:Patellar knee braceHinged knee braceSurgical:Gull-wing osteotomyPatellar resurfacing with biconvex patellaBulk allograft reconstructionPartial or complete patellectomyPatelloplastyInterpositional arthroplastyTantalum metal-backed reconstruction. There is a myriad of surgical options for severe patellar bone loss following TKA. Patellar bone-grafting is simple, reproducible, and relatively cost-effective1,2, and avoids the need for the amount of bone for reconstruction that may be required for metal-backed or biconvex patellar implants3,4. The procedure allows for the restoration of the quadriceps lever arm, which may not be restored with other techniques, such as gull-wing osteotomy or patellectomy5. Patellar bone-grafting avoids the cost and risks of disease transmission associated with allograft reconstruction6. Finally, the procedure provides excellent long-term survivorship and patient-reported outcomes. Following this procedure, patients should experience a reduction in knee pain and improved patient-reported outcomes2,6, with a prior study showing that the percentage of patients reporting anterior knee pain decreased from 51% to 27% following patellar bone-grafting. Patients also demonstrated an improvement in knee range of motion, with a mean increase in knee flexion of 7o and knee extension of 2o1. Complications related to this procedure are minimal. Bone stock restoration can be utilized for patellar resurfacing in the future1. Radiographically, patellar bone resorption, loss of patellar height, and patellar remodeling do occur; however, despite these radiographic changes, Knee Society scores increased from 50 to 85 at the time of the latest follow-up. Careful preoperative physical examination should document range of motion, areas of pain, and patellofemoral tracking and/or instabilityBe prepared to revise the femoral and/or tibial components if malrotated in order to optimize patellofemoral trackingRetain any autogenous bone harvested during component revision to use as patellar bone graftEnsure that allograft bone is available to ensure sufficient restoration of patellar thicknessConsider having allograft tissue available in the event that scar tissue in situ is not adequate to create an envelope for packing the bone graftA bleeding retropatellar surface prepared with a high-speed burr will increase the chance of bone incorporationA watertight closure of the soft-tissue envelope is critical to avoid loss of bone graft during knee range of motion.

A digital guiding device to facilitate cementation of porcelain laminate veneers

This article presents a computer-aided design and computer-aided manufacturing (CAD-CAM) guiding device to facilitate the simultaneous preconditioning and cementation of multiunit porcelain laminate veneers (PLVs). The guiding device was designed from the digital cast of the PLVs and definitive cast assembly, with gingival margins 2 mm from the PLV margins and lingual perforations and milled from a transparent polymethyl methacrylate (PMMA) disk. The PLVs were seated in the guiding device during the preconditioning procedures and transferred to the abutment teeth with luting cement loaded on the intaglio surfaces. Excess resin cement was removed while the guiding device held the PLVs in place. This technique provides predictable, accurate, and efficient simultaneous preconditioning and cementing of PLVs.

Dual-space technique for creating cement space in a cementation device for implant dentistry: A predictable chairside approach

As residual excess cement in peri-implant tissues is a problem that can lead to implant failure, great care must be taken when delivering cement-retained crowns. Cement selection, prosthetic design, and cementation techniques can reduce the chances of having excess cement in peri-implant tissues. Multiple techniques have been described, but, in many, the cement space has been reproduced by unreliable means. The dual-space technique allows the clinician to fabricate an implant crown delivery device in which the cement space has been replicated in a predictable and straightforward manner. In this technique, light-body impression material is used to create the luting space before the fabrication of the device with bis-acryl resin.