Detection of residual excess ZnO-based cement with laser fluorescence (DIAGNOdent): in vitro evaluation.

Because of its importance in the development of peri- implant mucositis and peri-implantitis, residual excess cement (REC) detection 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 ZnO-based 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 trans-gingival part of each implant was covered with 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 to evaluate the presence or absence of cement in a selected area by two independent examiners. The examiners were allowed to probe the gingival sulcus (2-mm depth) two times with a 5 min interval Between tests. The residual cement was recognized by gently walking the device tip around the implant. A detection score below 16 indicated an absence of cement and scores of 16 or higher indicated illustrated 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.