“Radiographic Appearance of Commonly Used Cements in Implant Dentistry” Pette, et. al., Int’l Journal of Periodontics and Restorative Dentistry. 2013).
Dental implants have revolutionized the field of dental medicine in how we can restore form and function to non-restorable, or missing teeth. Dental implants can be either screw-retained, cement retained, or a combination of both methods. Although cement retained dental implant crowns can improve esthetics, excessive cement has been shown to cause cement-induced peri-implantitis (Pette et. al, 2013). Clinicians should minimize extrusion of excess cement and also meticulously remove excess cement; however, excess or overhanging luting agent may be clinically undetectable. Radiography has the potential to detect sub-clinical levels of overhanging cement; however, radiographic detection of excess cement is limited to the materials radiopacity. The Pette et. al. study focuses on how cement-induced peri-implantitits can be prevented by increasing our diagnostic success by using luting agents that can be detected better radiographically.
Methods of Study:
Eighteen commercially available cements were prepared in 0.5mm and 1.0mm thick disks. Radiographs of samples were taken alongside an aluminum step wedge to quantify sample grayscale equivalence in terms of mm thickness of aluminum. Samples were exposed at 69kVp, 0.16 seconds, and 7mA at a distance of 130mm.
Of the 18 materials tested, 5 commercial cements were radiographically undetectable. This study shows that the most radiopaque materials either contained zinc (Durelon (not suitable to bonding to Ti framework), Temp Bond NE), resin-reinforced glass ionomer (GC Fuji Plus, and GC Fuji IX), or composite materials (Pette et. al., 2013).
The Pette study shows which commercially available luting agents have the highest radiopaque character that can aid in radiographic detection of excess cement that can cause cement-induced peri-implantitis, but it also emphasizes the importance of preventing cement-induced inflammation of the periodontium with improved clinical technique and awareness.