Replacement of a Perforated Upper Left Central Incisor: Early Placement of an RC Bone Level Implant
A 28-year-old patient presented at her general dentist’s office and complained about the appearance of her tooth 21. The patient had a history of trauma to this tooth. Endodontic treatment had been performed in the past and a crown placed on the tooth. A procedure to replace the old crown was performed by her dentist; however, a perforation on the middle third of the root occurred, and extraction of tooth 21 was suggested. Upon clinical and radiographic examination of the patient, who had been referred to us, replacement of tooth 21 by a dental implant appeared to be indicated.
General information
Case Type | Single-Tooth Space |
---|---|
Jaw | Maxilla |
Area | Anterior |
# of Teeth | 1 |
# of Implants | 1 |
Type of Implants | Two-Piece |
Attachment | Two-Piece |
Bone Augmentation | Horizontal|Simultaneous |
---|---|
Augmentation Materials | Autogenous chips|Xenogenous|Membrane |
Guided Surgery | No |
Soft Tissue Grafting | Staged |
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 | Advanced |
---|---|
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, allowing simultaneous augumentation |
Anatomic Risk | Low |
Esthetic Risk | High |
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 | Cemented, with prosthesis margin < 3mm submucosal Cemented, with prosthesis margin < 3mm submucosal |
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 | Healthy |
---|
Prosthodontic SAC Modifiers
Soft Tissue Contour and Volume | Ideal |
---|
General SAC Modifiers
Oral Hygiene and Compliance | Good |
---|---|
Access | Adequate |
Craniofacial/Skeletal Growth | Completed |
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