Replacing Four Upper Incisors with a Screw-Retained Bridge on Two Implants
A 22-year-old female patient was referred to our office for implant therapy following an accident in which the patient lost the upper left central incisor (tooth 21). The adjacent teeth had also been damaged; the right central incisor (11) and both lateral incisors (12, 22) showed grade II mobility. Immediately after the accident the first dental intervention involved repositioning of the mobile teeth and rigid splinting .
Surgical SAC classification
Complex
Prosthodontic SAC classification
Complex
Learner Level
|
1
|
2
|
3
|
Source
Treatment Guide 11
CME/CPD
0.15 hours
Purchase price
10
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General information
| Case Type | Extended Space |
|---|---|
| Jaw | Maxilla |
| Area | Anterior |
| # of Teeth | 4 |
| # of Implants | 2 |
| Type of Implants | Reduced-Diameter|Two-Piece |
| Attachment | Reduced-Diameter|Two-Piece |
| Bone Augmentation | Horizontal|Simultaneous |
|---|---|
| Augmentation Materials | Allogenous|Xenogenous|Membrane |
| Guided Surgery | Yes |
| Soft Tissue Grafting | - |
| 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 | More than three missing teeth to be replaced with an implant-borne prosthesis or prostheses |
| Modality | Modality |
| Placement Protocol | Immediate implant placement |
| Tooth Site | Maxillary incisor or canine |
| Socket Morphology | Single-root socket |
| Socket Integrity | Damage to one or more bone walls |
| Bone Volume | Damage to one or more socket walls |
| Anatomic Risk | Low |
| Esthetic Risk | High |
| Complexity | Low |
| Risk of Complications | High |
Prosthodontic SAC classification
| SAC Level | Complex |
|---|---|
| Defining Characteristics | Up to three missing teeth to be replaced with an implant-borne restoration or restorations |
| Loading Protocol | Immediate |
| Retention | - |
| Maxillomandibular Relationship | - |
| Mesio-Distal Space | Adequate for the replacement of all missing teeth |
| Inter-Arch Distance | - |
| Bruxism | - |
| Esthetic Risk | High |
| Provisional Implant-Supported Prosthesis | - |
| Interim Prosthesis during Healing | - |
| 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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