MilliporeSigma
  • Cement-associated signs of inflammation: retrospective analysis of the effect of excess cement on peri-implant tissue.

Cement-associated signs of inflammation: retrospective analysis of the effect of excess cement on peri-implant tissue.

The International journal of prosthodontics (2015-01-15)
Michael Korsch, Bernt-Peter Robra, Winfried Walther
ABSTRACT

Excess cement left in the peri-implant sulcus after the placement of prosthetic restorations risks inflammation in the peri-implant tissue. While many current studies deal with the question of how to avoid undetected excess cement, relatively little is known about the clinical consequences of this complication. This study analyzed the clinical findings associated with excess cement. Further, the influence of the sojourn time of undetected excess cement in the peri-implant pocket on clinical findings was investigated. Within the scope of a retrospective clinical follow-up, the suprastructures that were originally cemented with a methacrylate cement were revised in 93 patients (171 implants). The patients were split into two groups according to the time between placement of the prosthetic restoration and revision. Group 1 (G1) had treatment revisions within 2 years of restoration placement (71 patients with 126 implants); in group 2 (G2), treatment revisions were conducted at a later time (22 patients with 45 implants). For the purpose of statistical analysis, both groups were further analyzed based on the presence/absence of excess cement at the time of revision. By definition, the average time to revision in G1 was shorter than in G2 (0.71 years versus 4.07 years). There was no significant difference in the frequency of excess cement at revision between G1 (59.5%) and G2 (62.2%). The clinical findings around the implants in G1 were significantly less severe than in G2 (bleeding on probing: G1 without excess cement--17.6%, G1 with excess cement--80%, G2 without excess cement--94.1%, G2 with excess cement--100%; suppuration: G1 without excess--0%, G1 with excess cement--21.3%, G2 without excess cement--23.3%, G2 with excess cement--89.3%). After removing the excess cement, cleaning and disinfecting the implant abutment and restoration, and using a different cement, significantly fewer signs of inflammation were found at further follow-up in both groups. Within the limitations of this retrospective observational study, excess cement was present in a high number of cement-retained implant restorations. Signs of inflammation were present in a large proportion of implants at short- to medium-term follow-up. At the time of restoration revisions, the clinical observation of previously undetected excess cement was associated with increased prevalence of inflammation. Removal of excess cement significantly reduced the signs of inflammation.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Eugenol, ≥98%, FCC, FG
Supelco
Eugenol, certified reference material, TraceCERT®, Manufactured by: Sigma-Aldrich Production GmbH, Switzerland
Supelco
Eugenol, Pharmaceutical Secondary Standard; Certified Reference Material
Eugenol, European Pharmacopoeia (EP) Reference Standard
Supelco
Eugenol, PESTANAL®, analytical standard
Sigma-Aldrich
Eugenol, ReagentPlus®, 99%
Sigma-Aldrich
Eugenol, natural, ≥98%, FG
Chlorhexidine, European Pharmacopoeia (EP) Reference Standard
Sigma-Aldrich
Zinc oxide, puriss., meets analytical specification of Ph. Eur., BP, USP, 99-100.5% (calc. for dried substance)
Sigma-Aldrich
Zinc oxide, puriss. p.a., ACS reagent, ≥99.0% (KT)
Sigma-Aldrich
Zinc oxide, ReagentPlus®, powder, <5 μm particle size, 99.9%
Supelco
Chlorhexidine, Pharmaceutical Secondary Standard; Certified Reference Material
Sigma-Aldrich
Zinc oxide, nanowires, size × L × 1 μm
Supelco
Zinc oxide, analytical standard
Sigma-Aldrich
Zinc oxide, dispersion, nanoparticles, <100 nm particle size (TEM), ≤40 nm avg. part. size (APS), 20 wt. % in H2O
Sigma-Aldrich
Chlorhexidine dihydrochloride, ≥98%
Sigma-Aldrich
Zinc oxide, nanopowder, <100 nm particle size
Sigma-Aldrich
Zinc oxide, 99.999% trace metals basis
Sigma-Aldrich
Zinc oxide, nanopowder, <50 nm particle size (BET), >97%
Sigma-Aldrich
Chlorhexidine, ≥99.5%
Sigma-Aldrich
Zinc oxide, 99.99% trace metals basis
Chlorhexidine dihydrochloride, European Pharmacopoeia (EP) Reference Standard