Effect of luting materials on residual cement around cement-retained implant-supported dental restorations: A systematic review.

PURPOSE: Residual luting cement acts as a major risk factor for peri-implant tissues in cement-retained implant-supported restorations. This systematic review evaluates the effect of different luting materials on the presence and amount of residual cement. MATERIALS AND METHODS: Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and the population, intervention, comparison and outcome framework, reviewers searched PubMed/MEDLINE, Embase, Web of Science, Scopus and the Cochrane Library up to June 2025. Two independent researchers screened the literature and extracted data. Methodological quality and risk of bias were assessed utilising the Risk Of Bias In Non-randomized Studies of Interventions and quality assessment of risk of bias of in vitro studies tools. RESULTS: Ten studies (nine in vitro, one clinical) met the inclusion criteria. Resin-based cements left higher amounts of residual cement than zinc oxide-based cements, which yielded the lowest residue levels. Polycarboxylate and glass-ionomer cements demonstrated mixed outcomes. CONCLUSIONS: The physicochemical formulation of the luting material is the primary determinant of residual cement risk. Cements containing resin present the highest risk of undetected subgingival remnants, whereas zinc oxide-based materials offer a wider safety margin. Given that the current evidence base is predominantly derived from in vitro laboratory models, direct clinical recommendations should be approached with caution. CONFLICT-OF-INTEREST STATEMENT: The authors declare there are no conflicts of interest relating to this study.