DENTAL IMPLANT PLACEMENT CHECKLIST: SURGICAL PROTOCOL & RECOVERY Created by ChecklistGuro (https://checklistguro.com) --- 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 (°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) --- END OF TEMPLATE --- Transform this text into a digital, automated, and trackable mobile app! Visit: https://checklistguro.com/templates/dental-management/dental-implant-placement-checklist-surgical-protocol-recovery (Click "Install Template" to launch your digital inspection tool immediately)