After the surgery, there are two phases of monitoring the implant; the first one being the healing phase. Only after complete healing of the implant it is possible to characterise the second phase.
1. Phase of primary stability of implant
This phase begins with the placement of the implant in bone. It is expressed and measured in torque expressed in physical quantity N/cm. It is directly dependant on several variables: total bone volume in the area of implant intervention (width – height), bone quality (density, bone defects), the shape of the implant (length – width, the structure of threads), and the way of bone preparation.
2. Phase of secondary stability of implant
This phase is observed after the total healing of the implant in bone. Its monitoring has rather scientific significance. However, if any problems with the implant emerge, the information about its current stability is very important and the implantologist desides on further treatment of the patient based on the information.
System of medical checkups
After the operation the patient must follow the system of medical checkups. The system is individual for every patient. Generally the system of medical checkups can be categorised into several groups:
A. Replacement of single tooth by implant
The first medical examination is the check of dental hygiene one day before the intervention; thorough preoperative care of patient’s own teeth is expected. The next checkup of the oral cavity is conducted one week after the implant placement. The patient is instructed on the principles of hygiene around the implant. He/she is recommended a classic ultra soft toothbrush, a single toothbrush and if a temporary crown is placed, also an interdental brush.
Next checkup is immediately after the placement of a permanent crown. During this examination the patient obtains further instructions and the dentist advises him/her on the suitable interdental brush and dental floss. Two weeks after the placement of the permanent crown the patient comes for the next checkup during which the dentist checks if the patient can manage the implant care technique. The following checkup takes place three months later. If there are not any complications in the patient, he/she comes for regular checkups every six months.
B. Bridges on several implants
The first checkup takes place one week after the intervention and placement of a temporary bridge. The dentist checks dental hygiene. During this checkup the training for hygiene habits is conducted and the patient is informed on the use of an ultra soft toothbrush, an interdental brush, dental floss, and the application of rinsing the oral cavity with a 0.2% chlorhexidine digluconate solution. The rinsing should be performed for approximately two weeks.
Next checkup is one or two weeks after the placement of the permanent bridge. The patient is again informed about the requirements how to follow oral hygiene; during this checkup he/she is also recommended to use a single toothbrush and water flosser.
Following checkups are conducted in this type of implant treatment every three months. The dentist always checks oral hygiene. If the patient follows all instructions, the dentist will see a perfectly clean oral cavity. In case the dentist finds foulness of the bridge and implants, the bridge is removed, thoroughly cleaned and restored to the implants.
C. Patients with periodontitis
These patients are instructed on hygiene and cleaning immediately after the implant intervention when they are also explained how to use a single toothbrush, an interdental brush and dental floss. The patients are also recommended water flosser. Special supportive chemical substances are recommended in individual cases. The substances positively influence oral health and help preserve non-inflammatory condition around implants, or around patients‘ own teeth.
The following checkups take place every three months and the condition of periodontium as well as the surroundings of each and every implant is examined. Subgingival cleaning with special instruments (curettes) is performed in the patient every time when it is necessary.