In the medical history, the 55 year-old patient states that he has no systemic disease and is not taking any medication. The patient’s lifestyle is similarly unremarkable. The patient has a few tooth restorations and two implants (2nd and 4th quadrants). On the basis of current findings, gingivitis is identified in an otherwise stable periodontal condition on the reduced periodontium (stage III, grade A).

A 52-year-old patient presents at a prevention session. The patient has no systemic disease and is not taking any medication. He has had various dental treatments and also has two active carious lesions. In addition, the patient has four implants (2nd, 3rd and 4th quadrants). He is revealed to have early periodontal disease (stage IV, grade B). His periodontal condition is stable; a probe depth of 5 mm is only evident at the implant in region 36. Gingivitis is also identified.

Long-term success in implant therapy is an aim that all clinicians strive for. Fundamental to this is proper implant placement, surgical site preparation, and good osseointegration after insertion. Although a torque value is a basic prerequisite for primary stability, it alone does not provide complete information for the clinician. Therefore, knowledge of ISQ values is fundamental to assess both primary implant stability (mechanical stability) and secondary implant stability (biological stability or osseointegration).

Snus is usually brought into contact with the oral mucosa via its placement beneath the upper lip, and in some cases under the lower lip, whereby the nicotine it contains can enter the bloodstream via the oral mucosa