*3.1.3 Evaluation of implant mobility*

Test for implant mobility is a primary factor for identifying the longevity of implant health. Implant mobility can be tested either by the conventional method or by using automated devices. The conventional method uses two rigid instruments that apply a labiolingual force of 500 g around the implant fixture to test its rigidity. The automated devices currently in use are Periotest and a non-invasive device that works on the principles based on Resonance Frequency Analysis (RFA).

The amplitude of implant mobility can be assessed using the Implant mobility scale given by Misch [60] (**Table 5**).

#### *3.1.4 Occlusal evaluation*

Occlusal evaluation must be done at regular intervals. Any deflective or premature contacts that may cause loosening or fracture of abutment screws, implant, or prosthetic failure must be evaluated and corrected. Parafunctional habits if present must be documented and treated accordingly as they may cause rapid bone loss [47].

#### *3.1.5 Crestal bone loss and radiographic evaluation*

Loss of crestal bone is a significant indicator of any ongoing peri-implant disease. After the prosthesis delivery, crestal bone loss around implants can be a primary indicator


#### **Table 5.** *Clinical implant mobility scale.*

## *The Dental Implant Maintenance DOI: http://dx.doi.org/10.5772/intechopen.101187*

of the need for initial preventive therapy. Marginal bone loss of 0 to 0.2 mm after the first year of function is common and acceptable [61–63]. However, a bone loss of 0.5 to 1 mm after the abutment is connected and during the first few years of the prosthesis in function is an indicator of excessive stress at the crestal implant-bone interface [64]. The dentist should evaluate and reduce the cause of stress at the implant-bone interface which could be due to deflective occlusal contacts, cantilever length, or parafunction.


#### **Table 6.**

*At-home oral implant hygiene care aids.*

A preventive maintenance appointment should be scheduled every 3 to 4 months and a periapical/ bitewing radiograph should be made every 6 to 8 months. The periapical/ bitewing radiograph must be compared with the baseline radiographs to evaluate the crestal bone changes that have/have not occurred in the early stages of loading.

After 1 year, the previous radiographs must be compared with the recent bitewing radiograph and evaluated for further bone loss. If no changes are observed, a radiographic examination must be scheduled every 3 years, however, if there are noticeable unfavorable changes or crestal bone loss present, a radiographic evaluation must be carried out every 6–8 months along with stress reduction and hygiene maintenance protocol [60].
