Replacement of an Upper Right Lateral Incisor with a Narrow Neck Implant, Restored with a Ceramo-Metal Crown, Cemented
A healthy 32-year-old female patient presented at the clinic for recementation of a resin-retained fixed partial denture (RRFPD) and for a consultation on treatment options to replace the congenitally missing tooth 12. She desired a more esthetic and functional treatment option than her current one. A detailed examination of the teeth and periodontium adjacent to the edentulous space was performed to assess the esthetic risk for implant therapy. The intraoral exam revealed a pre-existing metal-reinforced RRFPD replacing tooth 12. Discoloration of teeth 13 and 11 due to the large metal retainers on the prosthesis was evident.The patient reported several occasions on which the prosthesis had debonded and had to be reinserted. It had become a nuisance for her,and she wanted a more permanent solution. Upon comparison of the adjacent lateral incisors, the mesiodistal width of 12 was slightly smaller and 22 was slightly undercontoured in its incisal embrasure.
Surgical SAC classification
Advanced
Prosthodontic SAC classification
Advanced
Learner Level
|
1
|
2
|
3
|
Source
Treatment Guide 1
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 | One-Piece|Reduced-Diameter |
| Attachment | One-Piece|Reduced-Diameter |
| Bone Augmentation | No |
|---|---|
| Augmentation Materials | - |
| 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 | 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 | 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 | Cemented, with prosthesis margin < 3mm submucosal Cemented, with prosthesis margin < 3mm submucosal |
| Maxillomandibular Relationship | Angle Class I and III |
| Mesio-Distal Space | Asymmetry greater than 1 mm |
| 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 | 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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