Replacement of an Upper Right Central and Lateral Incisor with an Implant-Supported Crown and a Distal Cantilever
This 20-year-old woman was referred to our department in July 2006. Four months earlier, she had experienced dental trauma to the anterior maxilla when traveling in South America. The emergency treatment included emergency root canal treatment of teeth 12 and 11. Tooth 21 was also subjected to endodontic treatment later. At the initial examination, the patient was not in pain but reported increased mobility of tooth 12. The clinical examination revealed a high smile line, medium thickness of the soft tissue, and rectangular tooth forms. Discoloration of tooth 12 was evident. The periapical radiograph provided by the referring dentist indicated a fracture line at both teeth 12 and 11. A cone-beam computed tomography (CBCT) scan confirmed these fractures. No pathology was found to be associated with tooth 21.
Surgical SAC classification
Advanced
Prosthodontic SAC classification
Advanced
Learner Level
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1
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2
|
3
|
Source
Treatment Guide 6
CME/CPD
0.15 hours
Purchase price
10
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General information
| Case Type | Short Space |
|---|---|
| Jaw | Maxilla |
| Area | Anterior |
| # of Teeth | 2 |
| # of Implants | 1 |
| Type of Implants | One-Piece |
| Attachment | One-Piece |
| Bone Augmentation | Horizontal|Simultaneous |
|---|---|
| Augmentation Materials | Autogenous chips|Xenogenous|Membrane |
| Guided Surgery | No |
| Soft Tissue Grafting | None |
| 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 | Up to three missing teeth to be replaced with an implant-borne prosthesis or prostheses |
| 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 | Up to three missing teeth to be replaced with an implant-borne restoration or restorations |
| Loading Protocol | Conventional or early |
| Retention | Screw-retained, with 2 unsplinted implants Screw-retained, with 2 unsplinted implants |
| Maxillomandibular Relationship | - |
| Mesio-Distal Space | Adequate for the replacement of all missing teeth |
| Inter-Arch Distance | - |
| 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 | Removable Removable |
| Occlusion/Articulation | Harmonious |
| 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 | In progress |
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