A 93-year-old female patient presented in September 2010 with an enlarged swelling on the lingual side of her lower incisors. At the time, she was essentially healthy, except for reduced vision due to bilateral age-related macular degeneration. She had been a heavy smoker (about 30 cigarettes a day) for the past 20 years after becoming a widow. The patient lived at home by herself, with full-time domestic support. An extraoral examination revealed nothing adverse. Intraoral plaque control was anything but ideal, and a soft-tissue tumescence was visible around the lingual aspect of 41–42. Because the nature of the lesion was not clear, a biopsy was carried out that revealed the inflammatory nature of the lesion. The panoramic radiograph showed six irregularly distributed mandibular implants supporting a full-arch prosthesis, with various degrees of interproximal peri-implant resorption. The periapical radiograph revealed interproximal bone resorption mesially and distally to implant 41.
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
More than 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
Horizontally and vertically sufficient
Anatomic Risk
Low
Esthetic Risk
Low
Complexity
Moderate
Risk of Complications
Low
Prosthodontic SAC classification
SAC Level
Advanced
Defining Characteristics
Up to three missing teeth to be replaced with an implant-borne restoration or restorations
Loading Protocol
Conventional or early
Retention
Screw-retained, with splinted implants Screw-retained, with splinted implants
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
Prosthodontic margin < 3 mm apical to mucosal crest Prosthodontic margin < 3 mm apical to mucosal crest
Interim Prosthesis during Healing
- -
Occlusion/Articulation
Harmonious
Occlusal Scheme/Issues
-
Surgical SAC Modifiers
Periodontal Status
History of periodontitis or genetic predisposition
Prosthodontic SAC Modifiers
Soft Tissue Contour and Volume
-
General SAC Modifiers
Oral Hygiene and Compliance
Insufficient
Access
Adequate
Craniofacial/Skeletal Growth
Completed
Publication date: May 4, 2017
Last review date: Apr 28, 2020
Next review date: Apr 28, 2023
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