Replacement of an Upper Right Central Incisor with Root Resorption: Ridge Preservation, Early Placement of an RC Bone Level Implant
A 49-year-old female patient was referred for implant therapy to replace the upper right central incisor (tooth 11). The tooth had been assessed by an endodontist who diagnosed a vertical fracture of the root. The tooth had a hopeless prognosis and needed to be extracted. The patient was healthy and was not taking any medications. She was allergic to penicillin. The patient had high esthetic demands but her expectations were realistic. The extraoral examination revealed no facial asymmetries. The right temporomandibular joint demonstrated an opening click but was otherwise asymptomatic. The lip line was high with a significant gingival display.
Surgical SAC classification
Complex
Prosthodontic SAC classification
Advanced
Learner Level
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1
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2
|
3
|
Source
Treatment Guide 10
CME/CPD
0.15 hours
Purchase price
10
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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 | Simultaneous|Vertical |
|---|---|
| Augmentation Materials | Autogenous chips|Xenogenous|Membrane |
| Guided Surgery | No |
| Soft Tissue Grafting | None |
| Abutment Type | CAD/CAM |
| 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 | 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 vertically or deficient vertically AND horizontally |
| Anatomic Risk | High |
| Esthetic Risk | High |
| Complexity | High |
| Risk of Complications | High |
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 | High |
| Provisional Implant-Supported Prosthesis | - - |
| Interim Prosthesis during Healing | Removable Removable |
| Occlusion/Articulation | - |
| Occlusal Scheme/Issues | - |
Surgical SAC Modifiers
| Periodontal Status | History of periodontitis or genetic predisposition |
|---|
Prosthodontic SAC Modifiers
| Soft Tissue Contour and Volume | Ideal |
|---|
General SAC Modifiers
| Oral Hygiene and Compliance | Insufficient |
|---|---|
| Access | Adequate |
| Craniofacial/Skeletal Growth | Completed |
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