Detection of Residual Excess Zinc Oxide-Based Cement With Laser Fluorescence (DIAGNOdent): In Vitro Evaluation

Because of its importance in the development of peri-implant mucositis and peri-implantitis, detection of residual excess cement (REC) is often the focus of studies addressing cement-retained implant-supported restorations. The purpose of this study was to evaluate the sensitivity and specificity of laser fluorescence (DIAGNOdent) for detecting residual excess zinc oxidebased cement around dental implants. In this in vitro study, 15 tissue-level implants were embedded in acrylic resin. To simulate gingiva around the implants, the transgingival part of each implant was covered with a gingival mask silicon material. Cement (Tempobond; 1 × 1 × 1 mm) was applied to 30 areas, 4 mm below the gingival-mimicking line using a custom-made template. A DIAGNOdent laser device was used by 2 independent examiners to evaluate the presence or absence of cement in a selected area. The examiners were allowed to probe the gingival sulcus (2-mm depth) 2 times with a 5-minute interval between tests. The residual cement was recognized by gently walking the device tip around the implant. A detection score less than 16 indicated an absence of cement, and scores of 16 or greater indicated the presence of excess luting agent in the implant sulcus. The sensitivity and specificity of DIAGNOdent to detect REC in the sulcus were 100% and 96.67%, respectively. Based on our findings, we propose that DIAGNOdent could be used to detect REC in the sulcus of cement-retained implant supported restorations.