After a crown is cemented what effect does any retained excess cement have?

When left behind, dental cements, whether they are of the traditional kind (the result of  acid/base salt reactions) or composite type, are irritating to the gums and can cause significant inflammation.  If there is excess cement left adjacent to a crown after cementation it should be removed by the dentist. This can be difficult at times, if it not removed before it is fully set. Fully set cements are hard and adherent and can require a significant force and are removed using an explorer, scaler or curette.

Often when checking for the presence of any leftover sub gingival cement I make use of my air syringe to gently blow into the sulcus. I use of a bright light attached to my loupes and when checking , I often find some residual cement that requires several attempts to remove. It can be annoying to the patient, who by the time of a crowns cementation maybe anxious to be finished. I usually apologize, but explain that it is important to remove all excess cement.

When examining some  patients radiographs it is not all that uncommon to see retained excess cement adjacent to previously cemented crowns. When observed,  I  notify the patient of its presence. This excess cement ,  on occasion, may play a role in the development of periodontal lesions that may include bone loss. Its removal is always a good idea, even if it is necessary to numb the patient up and use some "elbow grease" and a curette, to remove it.

Excess cement, in association with cemented implant crowns, has also  been implicated in the development of peri-implantitis  and is thought to be one of the possible cause of failing implants. Dentists are now taught to use extreme care when cementing implant crown so that no excess cement should be left behind after an implant crown is cemented.

Possibly one of the reasons that screw retained implant crowns are becoming more popular is that they are screwed into place and are cement free restorations. The fact remains that some implants are placed in a manner that will not allow a screw retained crown because the screw hole access would have to be placed towards the buccal or lingual of the crown. Recently, implant manufactures have designed "angled" channel screws that can be used for some of these implants and allow re-positioning of the access hole by up to 30 degrees and can allow for a greater percentage of screw retained crowns to be fabricated, even when an implant is slightly angled to the buccal or lingual.









from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2019/01/after-crown-is-cemented-what-effect.html - http://lspindelnycdds.blogspot.com/

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