The key things to be checked are:
- 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.
- We perform a periodontal probing and vigourously treat any periodontal disease as it will quickly spread to implants.
- 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.
- 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.
- Lateral guidance should ideally be on natural teeth.
- Any increase in probing depths around the implants should be followed by peri-apical radiographs taken with a long- cone paralleling device.
- All implant crowns should be checked for looseness and removed, cleaned and re-torqued as necessary.