Q&A with Dr. Hornbrook-Implant Crown Cementation

Question:

I wanted to ask you what you typically use for your implant crowns cementation – specifically metal abutment to porcelain crown vs. metal abutment to PFM.

In addition, I wanted to ask you what you recommend for a particular case – I did implant supported bridges and I have a situation with this patient where one of her implant bridges keeps coming out. I’ve tried several cements with no success.

-CG

Answer:

For the anterior, I always use a ceramic custom abutment with an all-ceramic crown so I bond it into place using a light cure resin cement.  My cement of choice is Variolink Esthetic LC from Ivoclar.  For posterior implant supported crowns, I try to do screw-retained, but if not possible, I will use a resin cement.  I like TheraCem (Bisco) because I obtain good adhesion, but it is also anti-bacterial.  This cement is also my cement of choice for ZrO2 crowns.

As far as your case, the question should be “why”?  Does it fit passively? Is there a balancing or working interference that is causing stress on the cement?…  Check that first.  If the answer is not, then I would clean the abutments with alcohol, isolate, and then pace a metal-primer (Z Prime +- Bisco) on the abutments and then bond into place using a dual cure resin cement.

-Dr. Hornbrook

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