ABOI/ID cheat sheet

Peri-implant health: no bleeding on gentle probing, no swelling, no bone loss beyond initial crestal remodeling; probing depths are not diagnostic alone.

Peri-implant mucositis: bleeding and/or suppuration on gentle probing with no progressive bone loss beyond initial remodeling.

Peri-implantitis: bleeding and/or suppuration on probing plus progressive bone loss; a common threshold is bone loss ≥2 mm or ≥3 threads from the implant shoulder.

Radiographic baseline should be taken at prosthesis delivery; later films are compared against that baseline, not against the placement film.

CBCT is not a routine screening tool; reserve it for suspected violations of vital structures, ridge deficiency, or unexplained symptoms.

Keratinized mucosa width <2 mm is associated with more plaque, bleeding, and recession; it is a risk indicator, not a diagnosis.

Risk assessment includes smoking, poorly controlled diabetes (HbA1c), history of periodontitis, parafunction, and oral hygiene capacity.

Implant mobility, rapidly progressive bone loss, and suppuration unresponsive to therapy suggest implant failure or infection requiring urgent evaluation.

Primary stability depends on bone density and implant geometry; ISQ ≥70 or insertion torque ≥35 Ncm generally permits immediate or early loading protocols.

Healing timelines: conventional loading 3 months in mandible and 4-6 months in maxilla; early loading 1 week to 2 months; immediate loading within 1 week.

Minimum 2 mm between adjacent implants and 1.5-2 mm between implant and adjacent tooth are typical spacing rules to preserve crestal bone and papilla.

Sinus floor elevation: crestal approach (osteotome) for limited residual height with adequate density; lateral window for severe pneumatization or height <4-5 mm.

Guided bone regeneration requires a barrier membrane plus graft, passive primary closure, and tension-free flap advancement; membrane exposure risks graft loss.

Implant site preparation should avoid thermal injury: copious irrigation, sharp drills, sequential enlargement, and controlled speed to keep bone below ~47°C.

Nerve proximity: a 2 mm safety margin from the inferior alveolar canal is standard; use CBCT measurement and surgical guides when proximity is close.

Immediate implant placement after extraction is contraindicated with active infection, insufficient apical bone, or inability to achieve primary stability.

Screw-retained restorations are preferred when access and angulation permit; cement-retained are used for esthetics or unfavorable angulation but require meticulous cement removal.

Provisional restoration should be out of occlusion in maximum intercuspation and excursive movements to protect the developing interface.

Impression timing depends on soft tissue healing and stability; verify osseointegration and absence of symptoms before final impressions.

Custom abutments and emergence profile design should support peri-implant soft tissue and allow cleansable contours.

Occlusal scheme: light centric contacts, no working or non-working interferences, and avoid cantilevers that concentrate load on the implant.

Torque values: abutment screws typically 20-35 Ncm per manufacturer; retighten after initial seating and verify with a calibrated torque wrench.

Passive fit is essential; an ill-fitting framework creates stress, screw loosening, and marginal bone loss. Verify with a single-screw Sheffield test or radiograph.

Implant-supported fixed prostheses should be retrievable where possible; design screw access and document torque values for future maintenance.

Maintenance intervals: 3 months for high-risk (smokers, periodontitis history, poor hygiene), 6 months for low-risk; adjust based on probing and bleeding trends.

Probing around implants should use light force (~0.25 N) with a plastic or metal probe; record depths, bleeding, and suppuration at each visit.

Peri-implant mucositis is reversible with nonsurgical debridement and improved hygiene; peri-implantitis requires surgical or combined therapy.

Radiographs at baseline, then every 1-2 years or when clinical changes appear; compare to the delivery baseline for bone-level trends.

Patients should be screened for peri-implant disease at every recall; untreated mucositis can progress to peri-implantitis.

Occlusal re-evaluation at recall detects wear, screw loosening, and parafunctional overload; adjust contacts as needed.

Systemic risk factors (smoking, diabetes, medications causing xerostomia) should be reassessed and managed to reduce long-term failure risk.

Document implant brand, lot, torque values, and restoration type; this information is critical for future complications and maintenance.