SFE with a Composite Graft Combined with Vertical Ridge Augmentation using Onlay Grafts and a Staged Approach
A 40-year-old woman with partial edentulism in both maxillary posterior segments was referred for consultation and treatment. Her main concern was the missing posterior teeth, which compromised mastication and were detrimental to her facial esthetics. She requested to have her appearance improved with a fixed prosthesis supported by oral implants. The patient reported a previous history of periodontal disease as the main cause of tooth loss in the posterior maxilla. She was in good general health, did not take any medications, and did not smoke.
General information
Case Type | Short Space |
---|---|
Jaw | Maxilla |
Area | Posterior |
# of Teeth | 6 |
# of Implants | 6 |
Type of Implants | Two-Piece |
Attachment | Two-Piece |
Bone Augmentation | Horizontal|Sinus Floor Elevation|Staged|Vertical |
---|---|
Augmentation Materials | Autogenous chips|Autogenous block(s)|Synthetic |
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 | Complex |
---|---|
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 vertically or deficient vertically AND horizontally |
Anatomic Risk | High |
Esthetic Risk | Low |
Complexity | High |
Risk of Complications | High |
Prosthodontic SAC classification
SAC Level | Straightforward |
---|---|
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 | Anatomic space corresponding to the missing teeth +/- 1 mm |
Inter-Arch Distance | < 8 mm or > 16 mm |
Bruxism | Absent |
Esthetic Risk | Low |
Provisional Implant-Supported Prosthesis | - - |
Interim Prosthesis during Healing | - - |
Occlusion/Articulation | Harmonious |
Occlusal Scheme/Issues | - |
Surgical SAC Modifiers
Periodontal Status | History of periodontitis or genetic predisposition |
---|
Prosthodontic SAC Modifiers
Soft Tissue Contour and Volume | - |
---|
General SAC Modifiers
Oral Hygiene and Compliance | Sufficient |
---|---|
Access | Adequate |
Craniofacial/Skeletal Growth | Completed |
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