Silicone Jig Technique for Cement-Retained Implant Supported Restoration

One of the most common complications with cement-retained implant restorations is inflammation around the crown. Excess cement can lead to peri-implant diseases such as peri-implant mucositis and even bone loss. A key factor to understand is the biological difference between teeth and implants — particularly the structure of the junctional epithelium and connective tissue — which makes removing residual cement around the restoration more difficult.

Here is a simple, step-by-step technique for fabricating a silicone jig to avoid excess cement in a cement-retained implant-supported restoration. It can be applied to a single crown or to an implant-supported cement-retained bridge.

Mitrani silicone jig technique for cement 01
Figure 1: Frontal view of a screw-retained implant-supported provisional restoration on a maxillary lateral incisor.
Mitrani silicone jig technique for cement 02
Figure 2: Frontal view of the peri-implant soft-tissue architecture after maturation.
Mitrani silicone jig technique for cement 03
Figure 3: Occlusal view of the peri-implant soft tissue. Note the adequate thickness of the buccal soft tissue.
Mitrani silicone jig technique for cement 04
Figure 4: Zirconia abutment on the master cast.
Mitrani silicone jig technique for cement 05
Figure 5: Layered zirconia crown on the master cast.
Mitrani silicone jig technique for cement 06
Figure 6: Zirconia abutment cemented to Variobase and layered zirconia crown designed for cementation.
Mitrani silicone jig technique for cement 07
Figure 7: Zirconia abutment secured to the implant and screw torqued to manufacturer’s recommendation.
Mitrani silicone jig technique for cement 08
Figure 8: Zirconia abutment in place. Note that the margin is accessible for cleaning after cementation.
Mitrani silicone jig technique for cement 09
Figure 9: Teflon tape is packed in the space between the abutment and the soft tissue.
Mitrani silicone jig technique for cement 10
Figure 10: A double Teflon cord technique is used by placing two different cords in the shape of a letter “C” to avoid any exertion of cement to the apical region.
Mitrani silicone jig technique for cement 11
Figure 11: Screw access is obliterated with Teflon tape (plumber’s tape).
Mitrani silicone jig technique for cement 12
Figure 12: Silicone material (Gingifast) is injected inside the crown using a fine tip. A fast-setting impression material, or bite registration silicone, can also be used.
Mitrani silicone jig technique for cement 13
Figure 13: View the result after the silicone material is completely set.
Mitrani silicone jig technique for cement 14
Figure 14: Cement is injected inside the crown depending on the case and the clinician’s choice of using temporary or permanent cement.
Mitrani silicone jig technique for cement 15
Figure 15: The crown with the cement is repositioned in the silicone jig, and all excess cement is removed with a microbrush.
Mitrani silicone jig technique for cement 16
Figure 16: Internal view of the crown with a minimal cement layer.
Mitrani silicone jig technique for cement 17
Figure 17: After cementation, the Teflon tapes are removed, and any excess cement will be attached to the tape.
Mitrani silicone jig technique for cement 18
Figure 18: Final view after cementation.
Mitrani silicone jig technique for cement 19
Figure 19: A final radiograph is taken to confirm the crown’s correct adaptation and ensure no excess cement.

References

  • Wadhwani, C., & Piñeyro, A. (2009). Technique for controlling the cement for an implant crown. Journal of Prosthetic Dentistry, 102(1), 57-58.
  • Present, S., & Levine, R. A. (2013). Techniques to control or avoid cement around implant-retained restorations. Compendium of Continuing Education in Dentistry, 34(6), 432-437.

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By: Ricardo Mitrani
Date: January 11, 2021


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