The key things to be checked are:

1. Patient’s plaque scores - we do a four-point plaque score on every tooth and implant. We note the presence or absence of plaque mesially, distally, buccally and lingually and collate this as a percentage score. We find that we need a plaque score of 10% or less to maintain peri-implant stability.
2. We perform a periodontal probing and vigourously treat any periodontal disease as it will quickly spread to implants.
3. We perform a peri-implant probing using a Hu-Freidy plastic periodontal probe. This probe is more flexible and will probe the peri-implant
   tissues more accurately. Any bleeding on probing around implants is not a good sign.
4. We check the occlusion and articulation. In light centric occlusion natural tooth pairs should occlude but the implants be free of occlusion when tested with shimstock. In firm-centric occlusion, the shimstock should then grip on the implants in occlusion.
5. Lateral guidance should ideally be on natural teeth.
6. Any increase in probing depths around the implants should be followed by peri-apical radiographs taken with a long- cone paralleling device.
7. All implant crowns should be checked for looseness and removed, cleaned and re-torqued as necessary.