DENTAL IMPLANT PLACEMENT CHECKLIST: SURGICAL PROTOCOL & RECOVERY

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--- PRE-OPERATIVE ASSESSMENT ---
[ ] Appointment Date
[ ] Medical History Review
[ ] Allergies (No Known Allergies, Medications, Latex, Other)
[ ] Blood Pressure (Systolic)
[ ] Blood Pressure (Diastolic)
[ ] Radiographic Imaging (CBCT/Pano)
[ ] Informed Consent Status (Signed and on File, To be Signed)

--- SURGICAL SITE PREPARATION ---
[ ] Anesthesia Type (Local Anesthesia, Sedation, General Anesthesia)
[ ] Anesthesia Dosage (mg)
[ ] Sterile Field Status (Confirmed, Pending)
[ ] Pre-op Radiograph Review
[ ] Surgical Guide Present? (Yes, No)
[ ] Guide Placement Verified (Y/N)
[ ] Preparation Start Time

--- IMPLANT OSTEOTOMY ---
[ ] Osteotomy Depth (mm)
[ ] Osteotomy Diameter (mm)
[ ] Drill Speed (RPM) (Low, Medium, High)
[ ] Irrigation Solution Used (Saline, EDTA, Hydrogen Peroxide)
[ ] Notes on Bone Density and Quality
[ ] Number of Drill Passes

--- IMPLANT PLACEMENT ---
[ ] Implant Depth (mm)
[ ] Angle of Placement (degrees)
[ ] Implant Brand (Straumann, Nobel Biocare, Bio-Tech, Osstem, Other)
[ ] Implant Diameter (mm) (3.5, 4.0, 5.0, 6.0, Other)
[ ] Initial Torque Value (Ncm)
[ ] Observations during Placement
[ ] Primary Stability (hand test) (Excellent, Good, Fair, Poor)

--- WOUND CLOSURE & DRESSING ---
[ ] Suture Type (Silk, Nylon, Chromic Gut, Vicryl Rapide)
[ ] Number of Sutures
[ ] Suture Technique (Simple Interrupted, Continuous, Mattress)
[ ] Dressing Type (Gauze, Non-Adherent Pad, Biopatch)
[ ] Dressing Instructions Provided
[ ] Dressing Change Time (if applicable)

--- POST-OPERATIVE INSTRUCTIONS ---
[ ] Detailed Pain Management Instructions
[ ] Dietary Restrictions and Recommendations
[ ] Oral Hygiene Instructions (Specific to Implant Site)
[ ] Prescription Refill Date (Pain Medication)
[ ] Follow-up Appointment Date
[ ] Scheduled Appointment Time (Follow-up)
[ ] Potential Complication Signs & Symptoms (Checklist) (Increased Pain, Swelling, Bleeding, Fever, Purulent Discharge)

--- INITIAL HEALING PHASE (WEEKS 1-3) ---
[ ] Date of Initial Post-Op Assessment
[ ] Vital Signs - Temperature (Â°C)
[ ] Vital Signs - Blood Pressure (mmHg)
[ ] Presence of Swelling? (None, Mild, Moderate, Severe)
[ ] Presence of Pain? (None, Mild, Moderate, Severe)
[ ] Pain Management Notes (if applicable)
[ ] Signs of Infection? (No, Yes - Describe in notes)
[ ] Additional Notes/Observations

--- OSSEOINTEGRATION ASSESSMENT (TYPICALLY 3-6 MONTHS) ---
[ ] Radiographic Assessment Date
[ ] Peri-implant Bone Level (mm) - Mesial
[ ] Peri-implant Bone Level (mm) - Distal
[ ] Bone Density Appearance (Cortical, Cancellous, Mixed)
[ ] Presence of Fibrous Tissue (Yes, No, Questionable)
[ ] Radiographic Image (Panoramic/CBCT)
[ ] Clinical Notes (e.g., presence of inflammation, exudate)

--- PROSTHETIC COMPONENT PLACEMENT ---
[ ] Impression Type (Digital, Alginate, PVS)
[ ] Impression Depth (mm)
[ ] Abutment Type (Stock, Custom, Angled)
[ ] Abutment Height (mm)
[ ] Impression Date
[ ] Impression Time
[ ] Master Cast Status (Created, Sent to Lab)

--- FINAL RESTORATION & PATIENT EDUCATION ---
[ ] Restoration Material
[ ] Occlusion - Angle (degrees)
[ ] Aesthetic Notes (Color Matching, Contouring)
[ ] Maintenance Instructions Provided (Brushing Technique, Flossing Technique, Recall Appointments, Professional Cleaning)
[ ] Next Recall Appointment
[ ] Patient Concerns/Questions
[ ] Patient Signature (Acknowledgement)

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