Post Implant Placement

• The continuation of antibiotics for one week past placement
  (Pen V.K. or Doxycyline in appropriate dose format is often utilized).
• Pain medication if indicated (Rarely necessary unless tissue flap was reflected in procedure).
• Tooth brushing with Scope instead of paste for 48 hours.
• Call patient at home within 48 hours to check for any problems and to answer questions.
• 7-day appointment to evaluate soft tissue healing and check for any infection.
• 90-day appointment to evaluate osseointergration by physical test and P.A. film. OK to laboratory to proceed with prosthetics if all is well. For D3 and D4 bone 6 months or more are needed for acceptable osseointergration before prosthetics are undertaken.

Post Prosthetics Placement

After placement of the crown(s), the patient must be put on a systematic recall system for routine evaluation.  The recalls should be at three-month intervals for the first year, then at the times of routine dental prophylaxis.  Some patients may still require more frequent follow-up.

Each recall visit should include the following:

1. Evaluation of the patient's oral hygiene (input from hygienist).  Periodontal problems can of course cause implant failure.  The patient's hygiene must be meticulous and remotivation initiated if necessary.
   
2. Gnathological evaluation to make sure there is no excessive stress on the implant(s).
   
3. Test the continued stability of the implant.  Radiographs should be taken to evaluate evidence of any bone resorption around the implant body.
   
4. Periodontal evaluation - A gingival index, including the evaluation of pocket depth around the circumference of the implant should be performed.
   
5. As the patient is dismissed, with the prosthetics in place, a short heart to heart talk about oral hygiene procedures must be initiated.  Flossing, micro brushing, rinsing, must be stressed now and with each follow-up appointment.