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

👥 Sara Moradianlotfi, Atieh Tavasol, Amirhossein Mohammadi, Fereshteh Eidy, Ali Babaei Zarch, Amir Kasaeian, Shirin Djalalinia, Marzieh Alikhasi

📔 European Journal of Prosthodontic & Restorative Dentistry (Q2)

🗓 August 2025

🗂 Review

📄 Abstract:

Background: Excess cement around implant-supported fixed restorations is a major problem that can lead to implant-related and aesthetic complications. Different abutment margin levels have been associated with the amount of residual cement.
Methods: A comprehensive search was performed in Medline/PubMed, Scopus, Web of Science, EMBASE, and Cochrane up to June 2023, using the PICO framework. Titles, abstracts, and full texts were independently screened by two authors. Risk of bias was assessed via the QUIN tool and ROBINS-I. A random-effects meta-analysis model was used.
Results: Twelve studies were included. Abutment margin levels considered included: 1 mm supragingival, at gingival level, 1 mm subgingival, and 3 mm subgingival. The combined mean excess cement for abutment margins of 1 mm supragingival was 0.04 ± 0.05 (I²=84%), at the gingival level 1.09 ± 2.0 (I²=49%), and 1 mm subgingival 1.18 ± 6.21 (I²=95%). The overall proportion of excess cement for abutment margins 1 mm subgingival and 3 mm subgingival were 0.26 (95% CI: 0.21-0.30) and 0.29 (95% CI: 0.25-0.34), respectively.
Conclusion: The level of the abutment margin is significantly associated with residual cement. Wherever possible, placing the abutment margin more gingivally or even supragingivally is advisable.

🔗 https://pubmed.ncbi.nlm.nih.gov/40748496/

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