Risk and Aesthetic Assesment in Implant Patient

The IDRA algorithm is a promising tool to assess patients at moderate or high risk of developing peri-implantitis. The eight vectors of the diagram include: an assessment of a history of periodontitis, the percentage of sites with bleeding on probing (BOP), the number of teeth/implants with probing depths (PD) ≥5 mm, the ratio of periodontal bone loss (evaluated from a radiograph) divided by the patient's age, periodontitis susceptibility as described by the staging and grading categories from the 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases , the frequency/compliance with supportive periodontal therapy, the distance from the restorative margin of the implant-supported prosthesis to the marginal bone crest, and prosthesis related factors including cleanability and fit of the implant-supported prosthesis.

With the pink aesthetic score, the post-implant process is scored according to the papilla, tissue contours, gingival level, alveolar process, color, and tissue condition. The thresholds for clinical acceptance, which was currently set at values of 8/14 for the PES. The thresholds for clinical acceptance are currently set at values of 8 to 14 for the PES.

The Implant Quality of The Health Scale allows the dentist to evaluate an implant using the listed criteria, place it in the appropriate category of health or disease, and then treat the implant accordingly. Three primary classes were established by the Consensus: success, survival, and failure. The success category describes optimum conditions, the survival category describes implants still in function but not with ideal conditions, and the loss of an implant represents an the implant that should be or already has been removed.

Implant Quality Scale Group Clinical Conditions

• Success (optimum health) a) No pain or tenderness upon function b) 0 mobility c) <2 mm radiographic bone loss from initial surgery d) No exudates history
• Satisfactory survival a) No pain on function b) 0 mobility c) 2-4 mm radiographic bone loss d) No exudates history
• Compromised survival a) May have sensitivity on function b) No mobility c) Radiographic bone loss> 4 mm(less than ½ of implant

It is advanced to the bone with a canal file. The distance between the stopper and the tip of the file is measured.

Keratinized mucosa width was defined as the distance between the gingival margin and mucogingival junction at the mid-buccal area

Measuring the distance from the gingival margin to the mucogingival line with a periodontal probe.

To determine the bleeding index on probing, the pocket floor, and the inflammatory state of the pocket epithelium, an evaluation is made according to whether there is bleeding in the sulcus 30 seconds after the pocket depth measurement from 6 regions of all the teeth of the patients: mesiobuccal, mid-buccal, distobuccal, mesiolingual, mid-lingual and distolingual.

Vestibular depth is measured either from crest of lip or from coronal border of the attached gingiva to depth of mucobuccal fold.

In the plaque index, the mesiobuccal, mid-buccal, distobuccal, mesiolingual, mid-lingual, and distolingual regions of the implant or implants and dental plaque thickness to the gingiva are evaluated by probing.

The gingival index evaluates bleeding, the most basic sign of inflammation. The implants' mesiobuccal, mid-buccal, distobuccal, mesiolingual, mid-lingual, and distolingual surfaces are measured.

Clinical attachment level/loss measured in mm as distance from the CEJ to the gingival margin.

Gingival recession is the exposure of the root surface resulting from migration of the gingival margin apical to the cementoenamel junction.