Probing

Monitoring peri-implant tissue condition

Radiographical check-ups to evaluate bone levels cannot be repeated too often to avoid unnecessary radiation. Monitoring the overlying soft tissues may help to identify eventual problems of the underlying bone, although the correlation of probing depth with crestal bone height falls as a site exhibits more soft tissue inflammation. Nevertheless, progressive increases in probing depth should lead to radiographic assessment to ascertain crestal bone height and any changes from previous viewed heights. 

Probing parameters

Probing disrupts the epithelial attachment to implant surfaces but does not cause permanent damage to the periimplant soft tissue seal. Mucosal penetration around endosseous implants is similar, but not identical, to penetration of periodontal tissues. Compared to teeth, the probe tip approximates crestal bone more closely and within 1-1.5 mm  The extent of probe penetration is influenced be the probing force, ideally 0.25 Newtons. Therefore, automated controlled-force probes offer better reproducibility of probing depth.  Other factors that influece probing depth are angulation, probe tip diameter, implant surface characteristics, presence of cement remnants, and degree of soft tissue inflammation. Using (flexible) plastic probes prevents scratching the abutment and prosthetic surfaces, which would favor plaque accumulation.

It is important to establish probing depths at the time of prosthesis placement to allow for comparison over time.  A recommended method is to identify a fixed reference point on the prosthesis and measure probing depth relative to this point.  However, occasionally, the prosthesis inhibits access and compromises angulation necessitating removal of the prosthesis.