Case

5.0The average rating is 5 stars out of 5.

Clinical Case Report

Early Placement of Implants in a Mandibular Left Second Premolar and Second Molar Site

Daniel Buser

A 56-year-old female patient was referred to the clinic for the functional rehabilitation of her left mandible. The healthy, non-smoking patient presented with loss of retention of crown 35 due to secondary root caries. In addition, she had a single-tooth gap at site 36 with clearly discernible facial atrophy. The panoramic radiograph exhibited crowned teeth 35 and 37, both with a root canal filling. Tooth 37 showed a radiolucent area on the mesial aspect. Tooth 38 did not show any signs of pathology. Based on the clinical and radiographic findings, it was decided to remove root 35 and tooth 37, creating an extended edentulous space with three missing teeth. As requested by the patient, tooth 38 was left in place. The removal of both teeth was done without major flap elevation. The wound margins at site 35 had to be slightly elevated to remove the root remnant.

Surgical SAC classification
Advanced
Prosthodontic SAC classification
Straightforward
Source
Treatment Guide 3
Purchase price
10 Academy Coins
CPD/CME
0.25 hours

Recommended content

General information

Case Type Short Space
Jaw Mandible
Area Posterior
# of Teeth 3
# of Implants 2
Type of Implants One-Piece
Attachment One-Piece
Bone Augmentation Horizontal|Simultaneous
Augmentation Materials Autogenous chips|Xenogenous|Membrane
Guided Surgery No
Soft Tissue Grafting None
Abutment Type Standard
Prosthesis Type FDP

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 Advanced
Defining Characteristics Up to three missing teeth to be replaced with an implant-borne prosthesis or prostheses
Modality -
Placement Protocol Early or late implant placement
Tooth Site -
Socket Morphology -
Socket Integrity -
Bone Volume Deficient horizontally, allowing simultaneous augmentation
Anatomic Risk Low
Esthetic Risk Low
Complexity Moderate
Risk of Complications Moderate

Prosthodontic SAC classification

SAC Level Straightforward
Defining Characteristics Up to three missing teeth to be replaced with an implant-borne restoration or restorations
Loading Protocol Conventional or early
Retention Cemented, with prosthesis margin < 3mm submucosal Cemented, with prosthesis margin < 3mm submucosal
Maxillomandibular Relationship -
Mesio-Distal Space Anatomic space corresponding to the missing teeth +/- 1 mm
Inter-Arch Distance > 8 mm
Bruxism Absent
Esthetic Risk Low
Provisional Implant-Supported Prosthesis - -
Interim Prosthesis during Healing - -
Occlusion/Articulation Harmonious
Occlusal Scheme/Issues -

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
Publication date: Jan 11, 2015 Last review date: Apr 10, 2022 Next review date: Apr 10, 2025

ITI QR code Mvc

Share this page

Download the QR code with a link to this page and use it in your presentations or share it on social media.

Download QR code
QR code