Case

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Replacement of a Failing Restored Upper Right Central Incisor, Ridge Preservation and Early Placement of an RC Bone Level Implant

Daniel S. Thoma

A 23-year-old female, healthy and non-smoking patient had had tooth 11 temporarily restored following a trauma in adolescence. As the patient’s growth had since come to an end and the crown had fractured, she requested an implant-supported restoration of tooth 11. Moreover, the contralateral tooth 21 presented an old composite restoration at the mesial incisal edge. The periodontal tissues were healthy with periodontal probing depth values below 3 mm, but some inflammation was observed around the semi-submerged root of tooth 11.
Surgical SAC classification
Advanced
Prosthodontic SAC classification
Advanced
Source
Treatment Guide 10
Purchase price
10 Academy Coins
CPD/CME
0.15 hours
Publication date: Mar 7, 2018 Last review date: Feb 28, 2018 Next review date: Feb 28, 2021

General information

Case Type Single-Tooth Space
Jaw -
Area -
# of Teeth -
# of Implants -
Type of Implants -
Attachment -
Bone Augmentation -
Augmentation Materials -
Guided Surgery -
Soft Tissue Grafting -
Abutment Type -
Prosthesis Type -

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 One missing tooth to be replaced by an implant-borne prosthesis
Modality -
Placement Protocol Early or late implant placement
Tooth Site -
Socket Morphology -
Socket Integrity -
Bone Volume Deficient horizontally, allowing simultaneous augumentation
Anatomic Risk Low
Esthetic Risk High
Complexity Moderate
Risk of Complications Moderate

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 High
Provisional Implant-Supported Prosthesis Prosthodontic margin > 3 mm apical to mucosal margin Prosthodontic margin > 3 mm apical to mucosal margin
Interim Prosthesis during Healing Removable Removable
Occlusion/Articulation -
Occlusal Scheme/Issues -

Surgical SAC Modifiers

Periodontal Status Healthy

Prosthodontic SAC Modifiers

Soft Tissue Contour and Volume Significantly deficient

General SAC Modifiers

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

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