Replacement of a Compromised Upper Right Central Incisor: Hard- and Soft-tissue Augmentation, Late Placement of an RC Bone Level Implant - Clinical Case Report - Academy
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Clinical Case Report
Replacement of a Compromised Upper Right Central Incisor: Hard- and Soft-tissue Augmentation, Late Placement of an RC Bone Level Implant
A 36-year-old male patient with a compromised maxillary central incisor was referred by his general dentist for consultation. The patient’s chief complaints were the gradual debonding of a temporary crown on the right central incisor and unsatisfactory esthetics due to an increasing diastema between the right central and lateral incisors. The patient reported a traumatic event some years previously, when a crown had been placed after root-canal treatment. The referring dentist wanted to provide a new crown restoration, but was concerned about the condition of the residual root. Anamnesis was negative for any other dental or periodontal pathology in the remaining dentition. The patient reported taking no medications: He was a smoker (10 to 15 cigs/day) and had realistic esthetic expectations.
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
Medium
Complexity
Moderate
Risk of Complications
Moderate
Prosthodontic SAC classification
SAC Level
Advanced
Defining Characteristics
One missing tooth to be replaced by an implant-borne crown
Loading Protocol
Conventional or early
Retention
Screw-retained Screw-retained
Maxillomandibular Relationship
Angle Class I and III
Mesio-Distal Space
Symmetry +/- 1 mm of contra-lateral tooth
Inter-Arch Distance
-
Bruxism
-
Esthetic Risk
Medium
Provisional Implant-Supported Prosthesis
Prosthodontic margin > 3 mm apical to mucosal margin Prosthodontic margin > 3 mm apical to mucosal margin
Interim Prosthesis during Healing
Removable Removable
Occlusion/Articulation
-
Occlusal Scheme/Issues
-
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
Publication date: Nov 7, 2017
Last review date: Oct 30, 2020
Next review date: Oct 30, 2023