Bilateral SFE in the Edentulous Maxilla with DBBM using a Staged Approach
A healthy 56-year-old woman was referred to our Department of Oral Implantology for complete rehabilitation of both jaws. She was a non-smoker and requested being treated with fixed restorations. The patient was dissatisfied with her appearance, particularly with the excessive length of her mandibular dentition. Her dental history was extensive. Over the previous 20 years, she had undergone periodontal and orthodontic treatment but also orthognathic surgery to advance the mandible. Clinical examination revealed good oral hygiene. The patient wore a maxillary denture, and the roots of teeth 13 and 23 were endodontically treated. Panoramic radiographs were obtained, indicating pneumatization of the sinuses and an inadequate vertical dimension of the alveolar process distal to both maxillary canines.
General information
Case Type | Edentulous Maxilla |
---|---|
Jaw | Maxilla and Mandible |
Area | Full-Arch |
# of Teeth | All |
# of Implants | 12 |
Type of Implants | One-Piece |
Attachment | One-Piece |
Bone Augmentation | Sinus Floor Elevation|Staged |
---|---|
Augmentation Materials | Autogenous chips|Xenogenous|Membrane |
Guided Surgery | No |
Soft Tissue Grafting | None |
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 | Fully edentulous upper jaw to be rehabilitated with four or more implants |
Modality | Fixed hybrid bridge on 5+ implants |
Placement Protocol | - |
Tooth Site | - |
Socket Morphology | - |
Socket Integrity | - |
Bone Volume | Deficient vertically or deficient vertically AND horizontally |
Anatomic Risk | High |
Esthetic Risk | High |
Complexity | High |
Risk of Complications | High |
Prosthodontic SAC classification
SAC Level | Complex |
---|---|
Defining Characteristics | Fully edentulous upper jaw to be rehabilitated with an implant-borne fixed dental prosthesis |
Loading Protocol | Conventional or early |
Retention | Screw-retained, with 4 or more splinted implants Screw-retained, with 4 or more splinted implants |
Maxillomandibular Relationship | - |
Mesio-Distal Space | - |
Inter-Arch Distance | Average |
Bruxism | Absent |
Esthetic Risk | High |
Provisional Implant-Supported Prosthesis | - - |
Interim Prosthesis during Healing | Removable Removable |
Occlusion/Articulation | - |
Occlusal Scheme/Issues | Anterior guidance |
Surgical SAC Modifiers
Periodontal Status | History of periodontitis or genetic predisposition |
---|
Prosthodontic SAC Modifiers
Soft Tissue Contour and Volume | Slightly compromised |
---|
General SAC Modifiers
Oral Hygiene and Compliance | Good |
---|---|
Access | Adequate |
Craniofacial/Skeletal Growth | Completed |
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