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/

Comments

Post a Comment

Popular posts from this blog

Help! My Child is Terrified of the Dentist

Image
If you’re the parent of a young child, you know their brains are similar to sponges that soak up everything around them—especially in their first five years, which neuroscientists say is when they’ll do the most learning and developing in their entire life. At this formative time, your child may amaze you with what they notice: your facial expressions, the different tones of your voice, and your habits. If your habits include regular dental visits and an excellent oral hygiene routine, they’ll notice and want to emulate you. If you happen to feel anxious about your dental visits, or you groan when you’ve got to floss and brush, they may synchronize and feel your dread. This could lead to dental fears that stick with them for years—potentially a lifetime! Kids Can Be Courageous If you’re feeling guilty right now, go ahead and put that away as it won’t serve you or your little one. Everyone has some room for improvement, and Coastal Pediatric Dentistry® is here to help show you an...
Read more

Going for the Gold?

Image
On the left is the older allow, on the right the new one that my lab has chosen to use The cost of a penny weight of pure gold is currently $79.53. The cost of a penny weight of pure palladium is $130.6. It used to be that palladium was added instead of gold to the precious metals often used for pfms, but now laboratories are finding that palladium is no longer affordable. The lab that I am using has just changed the formulation of the metal it's using to one that has more gold than palladium. I really do not mind, but metals with more gold are softer and often easier for a dentist to accidentally polish off delicate margins. It is important when polishing "higher gold" formulations to exert less hand pressure when performing the final polishing of the crown's margins. Other wise there should be no problem with this change. Traditionally labs have chosen alloys with higher gold percentages for optimal esthetics, since alloys with higher concentrations of ...
Read more

Lemon Juice – The Good, the Bad, & the Sour

Image
In a great tale of opposites, lemon juice can be both acidic and basic, or alkaline. Read on to find out why people are talking about this, and what it means for your oral and overall health . What is pH and why does it matter? Drinking lemon juice (usually diluted in a glass of water or added to a cup of tea) is a beloved health tonic among fans of natural medicine. Potential benefits include lower cholesterol, lower inflammation in the body, and increased metabolism and energy. Lemon also contains high levels of antioxidants and vitamin C that boost your immune system. On a scale from 0-14, a pH of 7 is neutral (pure water) while numbers below 7 are acidic (unhealthy), and above 7 are basic or alkaline (healthy). Believers in holistic health blame many ailments on the body’s pH being too low or too acidic. Increasing your body’s pH is called “alkalizing.” Lemon juice in its natural state is acidic with a pH of about 2, but once metabolized it actually becomes alkaline with a pH ...
Read more