Abutment Margin Level and Residual Cement Around the Dental Implant: A Systematic Review and Meta-Analysis

Background: Excess cement around implant-supported fixed restorations is a major shortcoming that can lead to implant-related and aesthetic-related problems. Different abutment marginal levels are cited as related to excess cement. Methods: A comprehensive search was conducted in Medline/PubMed, Scopus, Web of Science, EMBASE, and Cochrane based on the PICO strategy up to June 2023. Two authors independently screened the titles, abstracts, and full texts subsequently. The QUIN tool and Robins-I assessed the risk of bias. A random effect model was used for meta-analysis. Results: A total of 12 articles were included. Different abutment marginal levels including 1mm supragingival, at the gingival level, 1 mm subgingival, and 3 mm subgingival were assessed in the analysis. The combinemean excess cement of the abutment’s margins 1 mm supragingival, at the gingival level, and 1mm subgingival were 0.04±0.05 (I2=84%, CI=95%), 1.09±2.0 (I2=49%, CI=95%), and 1.18±6.21 (I2=95%, CI=95%), respectively. The overall proportion of excess cement in the abutment’s margins of 1 mm subgingival and 3 mm subgingival level were 0.26 (CI=95%, 0.21;0.3) and 0.29 (CI=95%, 0.25; 0.34). Conclusion: The abutment margin level was related to residual cement. Placing the abutment margin levels more gingivally, and even supra-gingivally wherever possible, seem necessary.

Dental Implants Dental Prosthesis Dental Cements Dental Abutment Residual Cement