Endoscopical detection of prosthetic residual cement and its correlation to peri-implant condition

Background and Aim: Cementation of the prosthetic crown on implants is a widespread fixation method. One of the main critical issues of this technique is to efficiently remove cement remnants(CE) below the mucous margin. Their permanence has been associated to an inflammatory response by the surrounding tissues. The main objective of this study is to evaluate the presence of submucosal CE in peri-implant disease cases under endoscopic vision. The correlation between the pathological condition and the apical position of CE has been also investigated.Methods: Fortysix patients with clinical and/or radiographic signs of peri-implant disease (mucositis or peri-implantitis) were included. All patients had a definitive cemented prosthesis loaded for at least3 months. Patients with mucositis were treated with gentle debridement and re-evaluated at 1 month; if mucositis was resolved the patient was not included in the study. All enrolled patients underwent to endoscopic analysis (DV2 Perioscope) at the implant site, to identify eventual submucosal CE. The proximity of CE to implant platform was measured by means of a periodontal probe (PCP UNC-15) under endoscopic vision. Results: CE was detected in 37 out of 46 implants (80.4%) and were mainly located at vestibular and lingual or palatal areas. The most apical portion of the CE was located at 1.80 mm from the edge of the implant platform. This distance was lower for implants with a diagnosis of peri-implantitis (1.11 mm) than in sites with mucositis (2.21 mm)(p=0.001).Conclusions: The presence of CE was strongly associated with peri-implant disease. The proximity of CE to implant platform was correlated to the severity of peri-implant disease.