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Treatment Algorithm · Module
Supportive peri-implant care: risk-based recall
Structuring the maintenance programme that keeps implants healthy after loading. What each recall visit must include, and how to set the interval from the patient's risk profile — anchored to the EFP S3 guideline and consensus on maintenance compliance.
Use: Maintenance & recall reference
Driver: Patient risk profile
Framework: EFP S3 (2023)
01 — Components
What every recall visit includes
Supportive peri-implant care (SPIC) is the structured programme delivered once implants are loaded and in function. Each visit combines diagnostic monitoring with professional biofilm removal and reinforcement of home care.
Diagnostic
Probing & bleeding
- Gentle peri-implant probing (~0.25 N) at all sites
- Record bleeding on probing (BOP) and suppuration
- Compare probing depths to a baseline reading
- Increasing depth + BOP signals disease onset
Diagnostic
Plaque & soft tissue
- Assess plaque / biofilm and oral hygiene
- Check mucosal health, keratinized tissue, recession
- Review prosthesis access & cleansability
- Reinforce individualized home care
Diagnostic
Radiographic monitoring
- Periapical radiograph when warranted by clinical signs
- Establish a baseline at restoration delivery
- Track marginal bone level vs. baseline
- Avoid routine fixed-interval imaging without indication
Therapeutic
Professional debridement
- Mechanical biofilm & calculus removal
- Use implant-safe instruments (PEEK/titanium/carbon-fiber tips, air-polishing)
- Avoid stainless steel curettes / metal ultrasonic tips on the surface
- Polish; reinforce home care before dismissal
Planning
Risk-based recall
- Set the next interval from the risk profile
- Default toward ≤ 6 months; tighten with risk
- Re-evaluate risk at each visit
- Escalate to treatment if mucositis / peri-implantitis found
02 — Decision Pathway
Interactive recall-interval selector
Stratify the patient by perio history, smoking, home-care compliance, and any prior peri-implant disease. The risk band sets the recall interval and the intensity of monitoring.
Tap the risk profile that best fits the patient.
Step 1 — What is the patient's peri-implant risk profile?
LOW
No perio history · non-smoker · good hygiene
Stable tissues, compliant home care, no prior peri-implant disease.
MODERATE
Treated periodontitis · or light smoker · inconsistent hygiene
One or two modifiable risk factors; no active disease.
HIGH
Prior peri-implant disease · heavy smoker · poor control
History of peri-implantitis, residual pockets, or multiple risk factors.
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03 — Quick Reference
Risk factor → recall interval → actions
A practical mapping of common risk drivers to maintenance frequency and emphasis. Intervals are guides — the final schedule is individualized and reassessed each visit. Consensus supports a minimum SPIC interval of about 5–6 months to reduce peri-implantitis risk.
| Risk factor | Recall interval | Emphasis / actions |
|---|
| None (stable, healthy) | ~6 months | Routine probing/BOP, plaque control, debridement; radiograph only if indicated. |
| History of periodontitis | 3–4 months | Combined perio + peri-implant monitoring; reinforce interdental cleaning. |
| Smoking | 3–4 months | Cessation counselling; close BOP / bone-level surveillance. |
| Poor home-care compliance | 3–4 months | Oral-hygiene re-instruction; assess prosthesis cleansability. |
| Prior peri-implant disease | ~3 months | Intensive surveillance; early re-intervention; treat residual pockets. |
| Poorly controlled diabetes | ~3 months | Coordinate glycemic control; tight monitoring for inflammation. |
Reference
Sources & clinical disclaimer
For licensed clinicians — educational use only. This algorithm summarizes published consensus and is not a substitute for individual clinical judgment, examination, or the standard of care in your jurisdiction. Recall intervals are individualized to the patient and reassessed at every visit; suspected mucositis or peri-implantitis requires definitive diagnosis and treatment.
- Herrera D, Berglundh T, Schwarz F, et al. Prevention and treatment of peri-implant diseases — The EFP S3 level clinical practice guideline. J Clin Periodontol. 2023;50(Suppl 26):4–76.
- Monje A, Aranda L, Diaz KT, et al. Impact of maintenance therapy for the prevention of peri-implant diseases: a systematic review and meta-analysis. J Dent Res. 2016;95(4):372–379.
- Heitz-Mayfield LJA, Aaboe M, Araujo M, et al. Group 4 ITI Consensus Report: diagnosis and non-surgical treatment of peri-implant diseases and maintenance care. Clin Oral Implants Res. 2018;29(Suppl 16):351–358.
Last reviewed: June 2026 · Next review due: June 2027 · Version 1.0