Implant Maintenance and Disease Prevention

Implant ChecklistHealth history, pharmacology, and dental

healthAssess Patient Self CareEvaluate Clinically and Radiographically Review and Document

What Do We See?Tissue consistency, form and colorInflammationBleedingExudateBone level (radiographic)Occlusion and parafunctional habitsMobility Patient hygiene adequacy

Peri-implant Mucositis

Signs of Peri-implant MucositisRed, shiny tissueSensitivityPresents of plaque and calculusBleedingInvolves soft tissue only

Peri-implantitis

Tissue Appearance In The Presence Of Peri-implantitisRed, purple, cyanoticGlossy, fibroticEnlarged, crateredBleedingExudate

Probing ConsiderationsPeri-mucosal sealPenetration of junctional epitheliumCloser to proximal bone than around a

natural toothDifficult to get the probe parallel to the long

axis of the implantSix sites are usually not attainableAnatomical situation is differentPocket ContaminationPotential for damage

Probing ParametersGentle PressureIn the 1st year all sites; evaluate color, form,

consistency, BOP, depthAfter 1 year of stable probing use

radiographs to check M/DCompare

Radiographs

•Monitor M/D Bone•Diagnostically Acceptable•Slight change from baseline•Capture most apical bone•Vertical BW offers the least degree of distortion

Implant MaintenanceRegular hygiene protocol (3-6 month

intervals)Scaling only in the presence of plaque or

calculusPolish with a fine paste onlyYearly radiograph of implant(s)

Patient EducationReview Homecare•Flossing Implants•Floss Threaders•Interdental brushes•Tapered end tuft brush•Antimicrobial Rinse

Auxiliary Aids