MODULE 5
Maintenance Protocols
Turn every implant case into a recurring revenue stream. Insert replacement schedules, maintenance billing codes, reline guidelines, and inventory management.
Every implant patient becomes a maintenance patient. Calculate your recurring revenue stream.
Maintenance Revenue
$25,000
50 × 2 × $250
Insert Revenue
$6,000
30 × $200
Total Annual Recurring
$31,000
Predictable income stream
Color-coded retention inserts wear over time. Use this guide to determine replacement timing and appropriate insert selection.
| Insert | Retention | Replace |
|---|---|---|
Blue (Light Retention) Start here for most patients | 1.5 lbs | 12–18 months |
Pink (Medium Retention) Most common long-term insert | 3.0 lbs | 12–18 months |
Clear (Heavy Retention) Higher retention = faster wear | 4.0 lbs | 9–12 months |
Red (Extra Light) Minimal retention, maximum ease | 0.5 lbs | 18–24 months |
Green (Extended Range) Compensates for up to 40° divergence | Variable | 12–18 months |
Visual Inspection
Examine peri-implant tissue for inflammation, recession, or swelling. Check for bleeding on probing.
Radiographic Assessment
Annual periapical radiographs to assess bone levels around implants. Compare to baseline.
Prosthesis Removal (Fixed)
For fixed prostheses: remove using LOCATOR seating tool in reverse. Clean prosthesis and abutments thoroughly.
Professional Cleaning
Use plastic or titanium scalers ONLY. Never use stainless steel instruments on implant components. Ultrasonic with plastic tip is acceptable.
Abutment Check
Verify abutment torque. Retighten if loose. Check for wear or damage to abutment surface.
Insert Assessment
Check retention level. If patient reports decreased retention, replace inserts. Bill D6091 per insert.
Occlusion Check
Verify occlusion with articulating paper. Adjust if needed. Check for wear patterns on prosthesis.
OHI Reinforcement
Review oral hygiene instructions. Demonstrate proper cleaning technique. Provide supplies if needed.
Documentation
Complete SOAP note. Record all findings, torque values, insert colors, and next appointment.
| Timeframe | Action | Code |
|---|---|---|
| 6-12 months post-delivery | Chairside soft reline | D5875 |
| 12-24 months | Laboratory hard reline | D5875 |
| 5-7 years | Prosthesis remake evaluation | D5110/D5120 or D5863/D5865 |
| As needed | Repair | D5511/D5512 or D5611/D5612 |
Keep these items stocked at all times. Assign one team member as inventory manager with monthly checks.