Replacement of Five Teeth with a Fixed Dental Prosthesis on Bone-Level Implants
A 52-year-old male patient presented at our clinic, his concern being that most of his maxillary anterior dentition (teeth 13 to 22) was missing. This extensive tooth loss was due to trauma, which had occurred several years previously, after which the patient had been wearing a removable partial denture. He stated that the residual roots were asymptomatic, did not express any other concerns, and reported not having a routine dental history with regular dental examinations. His medical history was uneventful, and he did not smoke. A clinical and radiographic examination revealed the presence of generalized periodontal disease associated with fair to poor oral hygiene, moderate plaque, subgingival fracture of teeth 13 to 22 with a poor prognosis, defective restorations on several teeth (18, 17, 14, 24, 25, 27, 37, 45, 47, 48), periapical radiolucencies around several teeth (38, 35, 33, 43, 47), and erosive/abrasive lesions on most teeth (notably in the fifth sextant).
Surgical SAC classification
Advanced
Prosthodontic SAC classification
Advanced
Learner Level
|
1
|
2
|
3
|
Source
Treatment Guide 6
CME/CPD
0.15 hours
Purchase price
10
You must be logged in to access or purchase this item.
There is a wealth of resources you can access by signing up
as an ITI Member. Learn more about ITI membership benefits.
General information
| Case Type | Extended Space |
|---|---|
| Jaw | Maxilla |
| Area | Anterior |
| # of Teeth | 5 |
| # of Implants | 3 |
| Type of Implants | Two-Piece |
| Attachment | Two-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 | More than 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 | Medium |
| 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 | Cemented, with prosthesis margin > 3mm submucosal Cemented, with prosthesis margin > 3mm submucosal |
| Maxillomandibular Relationship | - |
| Mesio-Distal Space | Adequate for the replacement of all missing teeth |
| Inter-Arch Distance | - |
| Bruxism | Present |
| Esthetic Risk | Medium |
| 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 | Irregular, with no need for correction |
| Occlusal Scheme/Issues | - |
Surgical SAC Modifiers
| Periodontal Status | History of periodontitis or genetic predisposition |
|---|
Prosthodontic SAC Modifiers
| Soft Tissue Contour and Volume | Slightly compromised |
|---|
General SAC Modifiers
| Oral Hygiene and Compliance | Insufficient |
|---|---|
| Access | Adequate |
| Craniofacial/Skeletal Growth | Completed |
Share this page
Download the QR code with a link to this page and use it in your presentations or share it on social media.
Download QR code