A 30-year-old female patient had lost tooth 21 and was referred to our clinic for consultation and treatment. Due to advanced apical infection, tooth 21 had been extracted two months earlier at another clinic and an acrylic-resin tooth had been bonded to the adjacent teeth. The patient desired implant treatment to avoid any damage to the adjacent natural teeth. While the patient had no history of any systemic disorder, she was a heavy smoker and exhibited medium to advanced periodontitis in the entire jaw. After the initial treatment to achieve a pocket probing depth of less than 4 mm and no bleeding on probing, a decrease in the height of the papillae mesial and distal to the extraction site and overall gingival recession were observed.
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 prosthesis
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
Complex
Defining Characteristics
One missing tooth to be replaced by an implant-borne crown
Loading Protocol
Conventional or early
Retention
Cemented, with meso-structure Cemented, with meso-structure
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
Fixed Fixed
Occlusion/Articulation
-
Occlusal Scheme/Issues
-
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
Publication date: Jan 11, 2015
Last review date: Apr 10, 2021
Next review date: Apr 10, 2024