A 73-year-old woman was referred to the Division of Periodontology (University of Geneva School of Dental Medicine) after repeated unsuccessful treatment of a peri-implant infection. She was systemically healthy and did not smoke. The patient’s history revealed that, three years earlier, an immediate implant (Straumann Tapered Effect RN 4.8/4.1; Institut Straumann AG, Basel, Switzerland) had been inserted to replace the upper right central incisor. A metal-ceramic crown had been delivered using an adhesive resin cement. One year later, the patient had consulted another dentist due to discomfort in the soft tissues in the implant region. There was a suppurating peri-implant pocket, 10 mm deep. Peri-implant bone loss and excess luting cement were seen on the radiograph. The situation was treated with non-surgical debridement, amoxicillin, and repeated submucosal irrigation with a chlorhexidine digluconate solution. The patient was referred after the suppuration had persisted for several months.
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
One missing tooth to be replaced by an implant-borne prosthesis
Modality
-
Placement Protocol
Immediate implant placement
Tooth Site
Maxillary incisor or canine
Socket Morphology
Single-root socket
Socket Integrity
Sufficient, with intact bone walls
Bone Volume
Sufficient, with intact walls
Anatomic Risk
Low
Esthetic Risk
Medium
Complexity
Moderate
Risk of Complications
High
Prosthodontic SAC classification
SAC Level
Advanced
Defining Characteristics
One missing tooth to be replaced by an implant-borne crown
Loading Protocol
Conventional or early
Retention
Cemented, with prosthesis margin > 3mm submucosal Cemented, with prosthesis margin > 3mm submucosal
Maxillomandibular Relationship
Angle Class I and III
Mesio-Distal Space
Symmetry +/- 1 mm of contra-lateral tooth
Inter-Arch Distance
-
Bruxism
-
Esthetic Risk
Medium
Provisional Implant-Supported Prosthesis
- -
Interim Prosthesis during Healing
- -
Occlusion/Articulation
-
Occlusal Scheme/Issues
-
Surgical SAC Modifiers
Periodontal Status
Healthy
Prosthodontic SAC Modifiers
Soft Tissue Contour and Volume
Ideal
General SAC Modifiers
Oral Hygiene and Compliance
Good
Access
Adequate
Craniofacial/Skeletal Growth
Completed
Publication date: Feb 25, 2016
Last review date: Feb 19, 2020
Next review date: Feb 19, 2023
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