Cement Application Techniques in Luting Implant-Supported Crowns: A Quantitative and Qualitative Survey

Purpose: To investigate different techniques used by dentists when luting an implant-supported crown and to evaluate the application of cement quantitatively and qualitatively. Materials and Methods: Participants were given a bag containing cement sachet, mixing pad, spatula, a variety of application instruments, and a polycarbonate crown form. The participants were instructed with a standardized audio-video presentation to proportion the cement, mix it, and apply it to the intaglio of the crown as they would if they were to cement it onto an implant abutment in a clinical situation. The crowns were weighed, first unfilled and then again once the applied cement had set. The mean weights of fully-loaded crowns (n = 10) were used as a control group. The patterns of cement loading were recorded. The weights of collected cement-loaded crowns were compared to those of the control group and analyzed statistically. Results: Four hundred and one dentists in several different geographic locations were surveyed. Three distinct cement loading patterns were observed: gross application (GA), brush-on application (BA), and margin application (MA). The mean weights for each cement loading pattern were 242.2 mg for the GA group, 59.9 mg for the BA group, and 59.0 mg for the MA group. The weight of cement in the GA group was significantly higher than that in the other groups. No statistically significant difference between groups BA and MA was seen. Conclusions: The diversity of the cement loading patterns disclosed in this study indicates that there is a lack of uniformity and precision in methods and a lack of consensus in the dental community regarding the appropriate quantity of cement and placement method for a cement-retained implant crown. Keywords: cement-retained implant crown, cement volume, dental cement, luting cement application