In 2004, an 84-year-old female patient presented at our practice with a hopeless prognosis for her maxillary right first and second premolars. These teeth were supporting a three-unit fixed dental prosthesis and had a cantilevered pontic replacing the first molar. Both teeth had combined endodontic and periodontal lesions, with significant bone loss in the area. The patient also had a large maxillary sinus apical to the first molar site. The patient presented with normal facial form and upon normal smiling, she displayed the affected area. She reported mobility and pain with mastication. The fixed dental prosthesis displayed severe mobility and could be depressed into the alveolar sockets. Exudate was evident around both abutments. There were no significant medical problems reported and the patient reported taking no medications.
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
Up to three missing teeth to be replaced with an implant-borne restoration or restorations
Modality
-
Placement Protocol
Early or late implant placement
Tooth Site
-
Socket Morphology
-
Socket Integrity
-
Bone Volume
Deficient vertically or deficient vertically AND horizontally
Anatomic Risk
High
Esthetic Risk
Low
Complexity
High
Risk of Complications
High
Prosthodontic SAC classification
SAC Level
Straightforward
Defining Characteristics
Up to three missing teeth to be replaced with an implant-borne restoration or restorations
Loading Protocol
Conventional or early
Retention
Cemented, with prosthesis margin < 3mm submucosal Cemented, with prosthesis margin < 3mm submucosal
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
- -
Interim Prosthesis during Healing
Removable Removable
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
Sufficient
Access
Adequate
Craniofacial/Skeletal Growth
Completed
Publication date: Jan 11, 2015
Last review date: Apr 10, 2021
Next review date: Apr 10, 2024
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