Case

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Conventional Loading of Two Implants in the Mandible and Final Restoration with a Bar-Supported RDP

Henny J.a. Meijer

A 63-year-old female patient was referred to the University Medical Center in Groningen, Netherlands, for dental implant treatment. The patient had been edentulous in the upper jaw for 20 years. The remaining teeth in the lower jar had been removed two years before the consultation. The patient was wearing her first maxillary denture and her second mandibular denture; the latter was 1 year old at the time. The conventional upper denture had functioned satisfactorily for many years, but the patient complained about reduced stability and insufficient retention of her lower conventional denture. Her medical history revealed no significant findings. The intraoral examination revealed minor resorption of the maxillary alveolar process and extreme resorption of the mandibular alveolar process.

General information

Case Type Edentulous Mandible
Jaw Mandible
Area Full-Arch
# of Teeth All
# of Implants 2
Type of Implants One-Piece
Attachment One-Piece
Bone Augmentation No
Augmentation Materials -
Guided Surgery No
Soft Tissue Grafting None
Abutment Type Standard
Prosthesis Type RDP

Esthetic Risk Assessment

Esthetic Risk Factors Low Medium High
Medical Status Healthy Compromised
Smoking Habit Non-smoker Light smoker (< 10 cigarettes per day) Heavy smoker (≥ 10 cigarettes per day)
Patient's Esthetic Expectations Low Medium High
Lip Line No exposure of papillae Exposure of papillae Full exposure of mucosa margin
Periodontal Phenotype Low-scalloped, thick Medium-scalloped, medium-thick High-scalloped, thin
Shape of Tooth Crowns Rectangular Triangular
Infection at Implant Site None Chronic Acute
Bone Level at Adjacent Teeth ≤ 5 mm to contact point 5.5 to 6.5 mm to contact point > 7 mm to contact point
Prosthodontic Status of Neighboring Teeth Virgin Restored
Width of Edentulous Span 1 tooth (≥ 7 mm) 1 tooth (< 7 mm) 2 teeth or more
Soft Tissue Anatomy Intact Defective
Bone Volume Horizontally and vertically sufficient Horizontally deficient Deficient vertically or deficient vertically AND horizontally
  • * General SAC assessment modifiers that are also part of the ERA. To avoid redundancy they are listed in this section even if no complete ERA has been made.

  • ** Not applicable to the ERA of immediate placement cases and replaced by "Socket Integrity" listed below under "Surgical SAC Classification". For all other placement types this value is a classification determinant and listed here even if no complete ERA has been made.

Surgical SAC classification

SAC Level Straightforward
Defining Characteristics Fully edentulous lower jaw to be rehabilitated with two or more implants
Modality 2 interforaminal implants
Placement Protocol -
Tooth Site -
Socket Morphology -
Socket Integrity -
Bone Volume Horizontally and vertically sufficient
Anatomic Risk Low
Esthetic Risk Low
Complexity Low
Risk of Complications Low

Prosthodontic SAC classification

SAC Level Advanced
Defining Characteristics Fully edentulous lower jaw to be rehabilitated with an implant-borne removable overdenture
Loading Protocol Conventional/early
Retention - -
Maxillomandibular Relationship -
Mesio-Distal Space -
Inter-Arch Distance -
Bruxism Absent
Esthetic Risk Low
Provisional Implant-Supported Prosthesis - -
Interim Prosthesis during Healing Removable Removable
Occlusion/Articulation -
Occlusal Scheme/Issues Balanced

Surgical SAC Modifiers

Periodontal Status Healthy

Prosthodontic SAC Modifiers

Soft Tissue Contour and Volume -

General SAC Modifiers

Oral Hygiene and Compliance Good
Access Adequate
Craniofacial/Skeletal Growth Completed

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