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Explore›Clinical Mistakes›Cement-retained restoration excess cement left behind

Cement-retained restoration excess cement left behind

AreaImplantology

What it is

Failing to completely remove excess luting cement from the subgingival margins of a cement-retained implant restoration. Residual cement acts as a foreign body in the peri-implant sulcus, triggering an inflammatory response that mimics or accelerates peri-implantitis.

Why it happens

• Deep subgingival margins (>1.5mm below tissue) making cement removal impossible • Using cements that are difficult to detect radiographically (composite-based cements are radiolucent) • Inadequate visibility during cementation (no magnification, poor light) • Not using a custom abutment with a defined cement margin at or slightly below tissue level • Over-loading cement — using too much and allowing excess to extrude subgingivally • Not taking a verification radiograph after cementation

The full clinical mistake entry includes

  • How to avoid it — the prevention protocol
  • The clinical tip experienced clinicians use
  • The documented reference behind the mistake
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More clinical mistakes

No prosthetically driven plan (implant placed where bone is)Skipping/poor CBCT-based risk assessment when neededWrong 3D implant positioning (too buccal/too deep/too shallow)Improper implant angulation compromising esthetics/prostheticsInadequate primary stability planning (bone quality not respected)Overheating bone during osteotomy (drilling errors)Wrong implant diameter/length selection for siteViolating vital structures (IAN/mental foramen/sinus/nasal floor)Poor soft-tissue management (thin biotype, no keratinized tissue plan)Immediate implant placement without correct case selectionImmediate loading without stability/occlusal control criteriaPoor emergence profile planning → hygiene difficulty

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