Abutment Margin Level and Residual Cement Around the Dental Implant: A Systematic Review and Meta-Analysis Publisher Pubmed



Moradianlotfi S ; Tavasol A ; Mohammadi A ; Eidy F ; Zarch AB ; Kasaeian A ; Djalalinia S ; Alikhasi M
Source: European Journal of Prosthodontics and Restorative Dentistry Published:2025

Abstract

Background: Excess cement around implant-supported fixed restorations is a major short-coming that can lead to implant-related and aesthetic-related problems. Different abutment marginal levels are cited as related to excess cement. Methods: A comprehensive search was conducted in Medline/PubMed, Scopus, Web of Science, EMBASE, and Cochrane based on the PICO strategy up to June 2023. Two authors independently screened the titles, ab-stracts, and full texts subsequently. The QUIN tool and Robins-I assessed the risk of bias. A random effect model was used for meta-analysis. Results: A total of 12 articles were included. Different abutment marginal levels including 1mm supragingival, at the gingival level, 1 mm subgingival, and 3 mm subgingival were assessed in the analysis. The combine-mean excess cement of the abutment’s margins 1 mm supragingival, at the gingival level, and 1mm subgingival were 0.04±0.05 (I2=84%, CI=95%), 1.09±2.0 (I2=49%, CI=95%), and 1.18±6.21 (I2=95%, CI=95%), respectively. The overall proportion of excess cement in the abutment’s margins of 1 mm subgingival and 3 mm subgingival level were 0.26 (CI=95%, 0.21;0.3) and 0.29 (CI=95%, 0.25; 0.34). Conclusion: The abutment margin level was related to residual cement. Placing the abutment margin levels more gingivally, and even supra-gingivally wherever possible, seem necessary. © 2025 Elsevier B.V., All rights reserved.