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A technique for minimizing subgingival residual cement by

using rubber dam for cement-retained implant crowns
Chi-Won Seo, DDS, MSDa and Jae-Min Seo, DDS, MSDb

Excellent esthetics and a passive fit are facilitated by
using cement-retained prostheses. However, eliminating
residual cement is difficult in the subgingival area.
Residual cement may cause periimplantitis, gingival
swelling, pain, bleeding on probing, and other compli-
cations.1 Generally, the margin of an anterior implant
crown is placed in the subgingival area for esthetic
reasons. Because removing residual cement in
subgingival areas is difficult, techniques using abutment
replicas or Teflon tape have been introduced to minimize
the problem.2-4
The presented technique uses rubber dam to allow
only the minimal amount of residual cement to flow into
the subgingival area when cement-retained prostheses
with subgingival margins are delivered. The procedure
does not require any additional laboratory steps. More-
over, it enables the isolation of a prosthesis before the
cementation procedure. Since the cement does not flow
into the subgingival area, less bleeding may occur when
the residual cement is removed, thus causing less
discomfort. Furthermore, rubber dam protects the gingiva
from direct contact with the cement, thus decreasing
chemical irritation.
PROCEDURE
1. Cut a sheet of rubber dam (Blossom; Mexpo Intl Inc)
into a size approximating the mesiodistal width of

Figure 1. A, Make hole at center of rubber dam with explorer and place abutment. B, Connect abutment to fixture inside oral cavity. Do not cover
proximal contacts with rubber dam.

a
Resident, Department of Prosthodontics, Institute of Oral Bio-Science, School of Dentistry, Chonbuk National University and Research Institute of Clinical Medicine of
Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea.
b
Associate Professor, Department of Prosthodontics, Institute of Oral Bio-Science, School of Dentistry, Chonbuk National University and Research Institute of Clinical
Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea.

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Figure 2. A, Place crown over abutment and light polymerize for 1 to 2 seconds. B, Remove residual cement.

the edentulous area and make a hole in the center REFERENCES

with a dental explorer (EXDTU17/236; Hu-Friedy
Mfg Co).
2. Push the implant abutment (Myplant; RaphaBio Co)
through the hole of the rubber dam and place it
below the margin of the abutment (Fig. 1A).
3. Connect the customized abutment with rubber dam
to the implant fixture and tighten to 30 Ncm. Adjust
the occlusal contact of the restoration. After 10
minutes, retighten and seal the hole.5 Make sure not
to cover the proximal contacts with the rubber dam
(Fig. 1B).
4. Apply a small amount of cement (RelyX Unicem;
3M ESPE) along the margin of the crown6 and place
the crown over the abutment. Light polymerize for
an initial 1 or 2 seconds according to the manufac-
turer’s instructions (Fig. 2A).
5. Remove the initially polymerized cement and care-
fully cut the rubber dam with scissors and remove it
(Fig. 2B). After complete polymerization, ensure no
cement remains.
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abutments by using polytetrafluoroethylene tape. J Prosthet Dent 2014;112:
365-8.
5. Siamos G, Winkler S, Boberick KG. Relationship between implant preload and
screw loosening on implant-supported prostheses. J Oral Implantol 2002;28:
67-73.
6. Wadhwani C, Goodwin S. Cementing an implant crown: a novel measure-
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Relat Res 2014;18:97-106.
Corresponding author:
Dr Jae-Min Seo
Department of Prosthodontics and Institute of Oral Bioscience
School of Dentistry
Chonbuk National University
Geumam-dong, Jeonju
REPUBLIC OF KOREA
Email: jmseo@jbnu.ac.kr
Copyright © 2016 by the Editorial Council for The Journal of Prosthetic Dentistry.

THE JOURNAL OF PROSTHETIC DENTISTRY Seo and Seo