Patient Assessment

Implant Identification:

• Identifying the type of implants and suprastructure used is crucial. Tools like implant passports and implant recognition software can aid in identification (Michelinakis et al., 2006).

 

Relevant History:

• Collect information on previous surgeries, bone grafts, any history of complications, changes to implant-supported restorations, bleeding gums, suppuration, and cleaning methods. Also, assess risk factors for peri-implant diseases and general implant failure.

 

Assessment of Suprastructure:

• Examine suprastructures for defects, abnormalities, access for cleaning, and occlusal problems. Stable restorations do not need to be dismantled, but loose restorations should be disassembled for a better assessment of individual implants.
• Assessment of Individual Fixtures:
• Evaluate individual implants for mobility using clinical mobility tests and tools like Periotest readings, resonance frequency analysis, and implant stability quotient (ISQ) measurements (Choi et al., 2014; Park et al., 2010).
• Assess for bacterial deposits by examining plaque presence at the emergence portion of the implant restoration.

 

Assessment of Peri-Implant Soft Tissue:

• Check for visual signs of inflammation and infection.
• Palpate for suppuration, swelling, and tenderness.
• Probe for bleeding and measure pocketing and attachment loss.
• Evaluate for recession and perform a soft tissue aesthetic assessment, including the papillae, interdental space, mucosal type, and width of keratinised tissue around the implant.

 

Radiographic Assessment:

• Intraoral periapical radiographs are the preferred method for evaluating peri-implant bone loss (Kuhl et al., 2016). It is essential to establish an appropriate reference point for measuring bone loss and comparing previous radiographs to determine the progression of the disease.