Case

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Clinical Case Report

Replacement of an Upper Right Central Incisor with a Regular Neck Implant, Restored with an All-Ceramic Crown, Transocclusally Screw-Retained

Ronald Ernst Jung

This 37-year-old female patient, a non-smoker, complained about discomfort and gingival problems at tooth 11. She was in good general health, and her medical history was without significant findings. The clinical inspection of the oral cavity revealed a fistula originating at tooth 11. Radiological examination of the crowned tooth 11 re- vealed a root-canal filling, status after apicoectomy, and a large periapical bone defect, as well as secondary caries. The adjacent teeth, 21 and 12,were periodontally healthy. They had interdental composite fillings that the patient wanted replaced. The bone crest levels of teeth 12 and 21 well maintained, providing potential soft-tissue support.

Surgical SAC classification
Complex
Prosthodontic SAC classification
Advanced
Source
Treatment Guide 1
Purchase price
10 Academy Coins
CPD/CME
0.15 hours

Recommended content

General information

Case Type Single-Tooth Space
Jaw Maxilla
Area Anterior
# of Teeth 1
# of Implants 1
Type of Implants One-Piece
Attachment One-Piece
Bone Augmentation Staged
Augmentation Materials Autogenous chips|Xenogenous|Membrane
Guided Surgery No
Soft Tissue Grafting Staged
Abutment Type Customized
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 Complex
Defining Characteristics One missing tooth to be replaced by an implant-borne crown
Modality -
Placement Protocol Early or late implant placement
Tooth Site -
Socket Morphology -
Socket Integrity -
Bone Volume Deficient horizontally, requiring prior grafting
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 Screw-retained Screw-retained
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 - -
Occlusion/Articulation -
Occlusal Scheme/Issues -

Surgical SAC Modifiers

Periodontal Status Healthy

Prosthodontic SAC Modifiers

Soft Tissue Contour and Volume Slightly compromised

General SAC Modifiers

Oral Hygiene and Compliance Sufficient
Access Adequate
Craniofacial/Skeletal Growth Completed
Publication date: Jan 11, 2015 Last review date: Apr 10, 2022 Next review date: Apr 10, 2025

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