What is a potential disadvantage of a very thick cement mantle?

• A. Heat generation and cement fracture.
• B. Immediate loosening.
• C. No effect on outcome.
• D. Decreased implant stability due to reduced cement.

Answer: (A)

A very thick cement mantle raises the heat generated as the PMMA cement cures. That exothermic rise can cause thermal injury to the surrounding bone, including potential bone necrosis at the bone–cement interface, which compromises fixation. In addition, a thick layer can be more prone to internal stresses and crack formation within the cement itself, a fracture that can undermine the integrity of the cement mantle and the overall implant fixation. These factors together make heat generation and cement fracture a meaningful disadvantage of an excessively thick cement mantle. The other statements don’t align with this issue: immediate loosening isn’t an automatic result of thickness alone, and saying there’s no effect on outcome ignores the impact of thermal and mechanical stresses. A reduced cement layer would rather risk decreased stability, not a thick one.