4.3The average rating is 4 stars out of 5.

Early Implant Placement with GBR using DBBM

Stephen T Chen

Early (Type 2) placement in a healthy, non-smoking male patient aged 28 years who required removal and replacement of the maxillary right central incisor due to external root resorption. A horizontal bone deficit requires a simultaneous augmentation procedure. The overall esthetic risk is high due to the horizontal bone deficit, medium to high lip line with exposure of the soft tissue margin when smiling, and the patient’s high esthetic expectations. After flapless tooth extraction and a healing period of 6 weeks, a standard-diameter one-piece implant is placed. A gap between the implant and the facial bone wall is filled with autogenous bone chips harvested from the anterior nasal spine and covered with DBBM particles. Contour augmentation on the facial aspect is achieved using DBBM particles and a collagen membrane, according to the principles of guided bone regeneration (GBR). The flap is coronally repositioned for semisubmerged healing.
Surgical SAC classification
Prosthodontic SAC classification
0 minutes
Purchase price
32 Academy Coins
0.53 hours
Publication date: Jun 28, 2015 Last review date: Jun 23, 2020 Next review date: Jun 23, 2020

General information

Case Type Single-Tooth Space
Jaw Maxilla
Area Anterior
# of Teeth 1
# of Implants 1
Type of Implants Two-Piece
Attachment Two-Piece
Bone Augmentation Horizontal|Simultaneous
Augmentation Materials Autogenous chips|Xenogenous
Guided Surgery No
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 -
Defining Characteristics -
Loading Protocol -
Retention -
Maxillomandibular Relationship -
Mesio-Distal Space -
Inter-Arch Distance -
Bruxism -
Esthetic Risk High
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 -

General SAC Modifiers

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

ITI QR code Mvc

Share this page

Download the QR code with a link to this page and use it in your presentations or share it on social media.

Download QR code
QR code