Transition from an “irrational to treat” Maxillary Dentition to a Full-Arch Segmented FDP by Early Loading of Eight Implants Placed Using the Staged Approach
The staged approach permits the transition from an “irrational to treat”dentition to a full arch implant supported restoration without any need to use a removable provisional prosthesis or to apply the immediate-placement and immediate-loading techniques. A failing dentition is the usual indication for a staged treatment. On the other hand, the dentition should still contain many residual teeth, but with few or none of them being suitable for use as definitive abutments for a full-arch fixed restoration.This situation is usually the result of advanced periodontal disease or of the failure of an extensive fixed prosthesis.
Surgical SAC classification
Complex
Prosthodontic SAC classification
Complex
Learner Level
|
1
|
2
|
3
|
Source
Treatment Guide 4
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 | Edentulous Maxilla |
|---|---|
| Jaw | Maxilla |
| Area | Full-Arch |
| # of Teeth | All |
| # of Implants | 8 |
| Type of Implants | One-Piece |
| Attachment | One-Piece |
| Bone Augmentation | Horizontal|Simultaneous |
|---|---|
| Augmentation Materials | - |
| Guided Surgery | No |
| Soft Tissue Grafting | None |
| Abutment Type | Standard |
| 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 | Fully edentulous upper jaw to be rehabilitated with four or more implants |
| Modality | Fixed hybrid bridge on 5+ implants |
| Placement Protocol | - |
| Tooth Site | - |
| Socket Morphology | - |
| Socket Integrity | - |
| Bone Volume | Deficient horizontally, allowing simultaneous augumentation |
| Anatomic Risk | Moderate |
| Esthetic Risk | High |
| Complexity | High |
| Risk of Complications | High |
Prosthodontic SAC classification
| SAC Level | Complex |
|---|---|
| Defining Characteristics | Fully edentulous upper jaw to be rehabilitated with an implant-borne fixed dental prosthesis |
| Loading Protocol | Conventional or early |
| Retention | Cemented, with prosthesis margin < 3mm submucosal Cemented, with prosthesis margin < 3mm submucosal |
| Maxillomandibular Relationship | - |
| Mesio-Distal Space | - |
| Inter-Arch Distance | Average |
| Bruxism | Absent |
| Esthetic Risk | High |
| Provisional Implant-Supported Prosthesis | Prosthodontic margin < 3 mm apical to mucosal crest Prosthodontic margin < 3 mm apical to mucosal crest |
| Interim Prosthesis during Healing | Fixed Fixed |
| Occlusion/Articulation | - |
| Occlusal Scheme/Issues | Anterior guidance |
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 | Sufficient |
|---|---|
| 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