This case describes the ongoing management of a 64-year-old healthy, non-smoking female patient with erosive oral lichen planus (OLP) affecting the gingivae and the buccal and lingual mucosa. The peri-implant mucosa was also affected subsequent to implant placement. The patient had osseointegrated implants (four in the maxilla, four in the mandible) placed following extraction of hopeless teeth and a healing period. The patient had a history of OLP prior to implant placement and had been referred to an oral-medicine specialist for definitive diagnosis and treatment. She exhibited generalized oral mucosal involvement. Following a clinical assessment, biopsy, and blood tests, she was treated with topical corticosteroids. Systemic prednisolone was reserved for severe flare-ups. Amphotericin lozenges were used in combination with corticosteroid treatment to prevent the development of oral candidiasis.
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
Complex
Defining Characteristics
Fully edentulous upper jaw to be rehabilitated with four or more implants
Modality
Fixed hybrid bridge on 5+ implants
Placement Protocol
-
Tooth Site
-
Socket Morphology
-
Socket Integrity
-
Bone Volume
Deficient vertically or deficient vertically AND horizontally
Anatomic Risk
High
Esthetic Risk
Medium
Complexity
High
Risk of Complications
High
Prosthodontic SAC classification
SAC Level
Complex
Defining Characteristics
Fully edentulous upper jaw to be rehabilitated with an implant-borne fixed dental prosthesis
Loading Protocol
Conventional or early
Retention
Screw-retained, with 4 or more splinted implants Screw-retained, with 4 or more splinted implants
Maxillomandibular Relationship
-
Mesio-Distal Space
-
Inter-Arch Distance
Average
Bruxism
Absent
Esthetic Risk
Medium
Provisional Implant-Supported Prosthesis
Prosthodontic margin < 3 mm apical to mucosal crest Prosthodontic margin < 3 mm apical to mucosal crest
Interim Prosthesis during Healing
Removable Removable
Occlusion/Articulation
-
Occlusal Scheme/Issues
Anterior guidance
Surgical SAC Modifiers
Periodontal Status
History of periodontitis or genetic predisposition
Prosthodontic SAC Modifiers
Soft Tissue Contour and Volume
Significantly deficient
General SAC Modifiers
Oral Hygiene and Compliance
Sufficient
Access
Adequate
Craniofacial/Skeletal Growth
Completed
Publication date: Mar 29, 2016
Last review date: Mar 24, 2021
Next review date: Mar 24, 2024
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