Replacement of a Maxillary Left First Molar Using an Early Loading Protocol
A 28-year-old female patient was referred to our clinic for replacement of the upper left first molar with a dental implant and crown. The tooth had been removed six months before because of an endodontic complication. The patient’s main requests were restoration of her masticatory function and closure of the tooth gap at position 26. The patient was in good general health, and her medical history was without significant findings. There were no obstacles to implant therapy. The preoperative radiograph revealed a bone height sufficient for implant placement in a largely healed extraction socket with some endodontic filling material residue.
Surgical SAC classification
Straightforward
Prosthodontic SAC classification
Straightforward
Learner Level
|
1
|
2
|
3
|
Source
Treatment Guide 2
CME/CPD
0.15 hours
Purchase price
10
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General information
| Case Type | Single-Tooth Space |
|---|---|
| Jaw | Maxilla |
| Area | Posterior |
| # of Teeth | 1 |
| # of Implants | 1 |
| 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 | Straightforward |
|---|---|
| Defining Characteristics | One missing tooth to be replaced by an implant-borne crown |
| Modality | - |
| Placement Protocol | Early or late implant placement |
| Tooth Site | - |
| Socket Morphology | - |
| Socket Integrity | - |
| Bone Volume | Horizontally and vertically sufficient |
| Anatomic Risk | Low |
| Esthetic Risk | Low |
| Complexity | Low |
| Risk of Complications | Low |
Prosthodontic SAC classification
| SAC Level | Straightforward |
|---|---|
| Defining Characteristics | One missing tooth to be replaced by an implant-borne crown |
| Loading Protocol | Conventional or early |
| Retention | Cemented, with prosthesis margin < 3mm submucosal Cemented, with prosthesis margin < 3mm submucosal |
| Maxillomandibular Relationship | - |
| Mesio-Distal Space | Anatomic space corresponding to the missing tooth +/- 1 mm |
| Inter-Arch Distance | Ideal tooth height +/- 1 mm |
| Bruxism | Absent |
| Esthetic Risk | Low |
| 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 |
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