Dental Implant Placement Checklist: Surgical Protocol & Recovery
Ensure flawless implant procedures & patient healing. This Dental Implant Placement Checklist guides you through surgical protocols, post-op care, and recovery milestones for exceptional patient outcomes & confident compliance.
This Template was installed 3 times.
Pre-Operative Assessment
Review patient history, imaging (CBCT, Pano), and consent forms. Confirm medical clearance and allergies.
Appointment Date
Medical History Review
Allergies
Blood Pressure (Systolic)
Blood Pressure (Diastolic)
Radiographic Imaging (CBCT/Pano)
Informed Consent Status
Surgical Site Preparation
Ensure proper anesthesia, sterile field, and equipment setup. Verify implant site marking and surgical guide placement (if applicable).
Anesthesia Type
Anesthesia Dosage (mg)
Sterile Field Status
Pre-op Radiograph Review
Surgical Guide Present?
Guide Placement Verified (Y/N)
Preparation Start Time
Implant Osteotomy
Accurate osteotomy creation based on surgical plan. Verify depth and diameter. Irrigation and hemostasis.
Osteotomy Depth (mm)
Osteotomy Diameter (mm)
Drill Speed (RPM)
Irrigation Solution Used
Notes on Bone Density and Quality
Number of Drill Passes
Implant Placement
Correct angulation, depth, and primary stability. Verify tactile and radiographic assessment.
Implant Depth (mm)
Angle of Placement (degrees)
Implant Brand
Implant Diameter (mm)
Initial Torque Value (Ncm)
Observations during Placement
Primary Stability (hand test)
Wound Closure & Dressing
Appropriate suturing technique. Application of protective dressing. Patient education on post-operative care.
Suture Type
Number of Sutures
Suture Technique
Dressing Type
Dressing Instructions Provided
Dressing Change Time (if applicable)
Post-Operative Instructions
Provide detailed verbal and written instructions regarding pain management, diet, oral hygiene, and follow-up appointments.
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)
Initial Healing Phase (Weeks 1-3)
Monitor for signs of infection, inflammation, or implant failure. Assess soft tissue healing.
Date of Initial Post-Op Assessment
Vital Signs - Temperature (°C)
Vital Signs - Blood Pressure (mmHg)
Presence of Swelling?
Presence of Pain?
Pain Management Notes (if applicable)
Signs of Infection?
Additional Notes/Observations
Osseointegration Assessment (Typically 3-6 months)
Radiographic evaluation to confirm osseointegration. Assess peri-implant bone levels.
Radiographic Assessment Date
Peri-implant Bone Level (mm) - Mesial
Peri-implant Bone Level (mm) - Distal
Bone Density Appearance
Presence of Fibrous Tissue
Radiographic Image (Panoramic/CBCT)
Clinical Notes (e.g., presence of inflammation, exudate)
Prosthetic Component Placement
Confirmation of stability and accuracy. Impression taking and abutment selection.
Impression Type
Impression Depth (mm)
Abutment Type
Abutment Height (mm)
Impression Date
Impression Time
Master Cast Status
Final Restoration & Patient Education
Delivery of final restoration. Review occlusion, aesthetics, and maintenance. Long-term follow-up plan.
Restoration Material
Occlusion - Angle (degrees)
Aesthetic Notes (Color Matching, Contouring)
Maintenance Instructions Provided
Next Recall Appointment
Patient Concerns/Questions
Patient Signature (Acknowledgement)
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