Immediate Loading of Eight Implants in the Maxilla and Six Implants in the Mandible and Final Restoration with Three-Unit and Four-Unit FDPs
Extensive scientific evidence has confirmed that immediately loaded implants with fixed full-arch provisional restorations can osseointegrate with success rates similar to conventionally or delayed loaded implants. A number of immediate-provisionalization techniques for edentulous jaws have been described. Some protocols differ when it comes to prefabricated provisional templates versus complete denture conversion; intrasurgical impressions versus direct relining; and cemented versus screw-retained provisional restorations. In this context, complete-denture conversion has been proposed for either intrasurgical impressions or direct relining. Another possibility is the utilization of a prefabricated provisional to be adapted either in the mouth (by direct relining) or in the laboratory (on a working model obtained from an intrasurgical impression).
Surgical SAC classification
Complex
Prosthodontic SAC classification
Complex
Learner Level
|
1
|
2
|
3
|
Source
Treatment Guide 4
CME/CPD
0.25 hours
Purchase price
10
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General information
| Case Type | Edentulous Maxilla |
|---|---|
| Jaw | Maxilla and Mandible |
| Area | Full-Arch |
| # of Teeth | All |
| # of Implants | 14 |
| Type of Implants | One-Piece |
| Attachment | One-Piece |
| Bone Augmentation | No |
|---|---|
| Augmentation Materials | - |
| Guided Surgery | No |
| Soft Tissue Grafting | None |
| Abutment Type | Standard |
| 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 | 6+ implants with immediate loading |
| Placement Protocol | - |
| Tooth Site | - |
| Socket Morphology | - |
| Socket Integrity | - |
| Bone Volume | Horizontally and vertically sufficient |
| Anatomic Risk | Low |
| 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 | Immediate |
| Retention | Cemented, with prosthesis margin < 3mm submucosal Cemented, with prosthesis margin < 3mm submucosal |
| Maxillomandibular Relationship | - |
| Mesio-Distal Space | - |
| Inter-Arch Distance | Average |
| Bruxism | Absent |
| Esthetic Risk | High |
| Provisional Implant-Supported Prosthesis | Prosthodontic margin < 3 mm apical to mucosal crest Prosthodontic margin < 3 mm apical to mucosal crest |
| Interim Prosthesis during Healing | - - |
| Occlusion/Articulation | - |
| Occlusal Scheme/Issues | Anterior guidance |
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 |
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