Treatment of Advanced Peri-Implantitis by Implant Removal Followed by Bone Reconstruction and New Implant Placement
Paolo Casentini and Matteo Chiapasco present a case in which the peri-implant defect was not suitable for a fully regenerative approach. It involves implant removal, use of a CAD/CAM customized titanium mesh in the grafting phase, and placement of new implants. A 62-year-old woman was referred for consultation regarding her implant-supported prosthesis replacing teeth 14 to 16. The patient’s main concern was pain and recurrent swelling in the right posterior maxilla. The patient also reported difficulty and discomfort when brushing the area. The patient reported she had been treated in another country, where she had received three implants in combination with sinus-floor augmentation for the replacement of the posterior maxillary teeth three years earlier. The patient indicated “endodontic complications” to be the reason for the extraction of the teeth.
Surgical SAC classification
-
Prosthodontic SAC classification
-
Learner Level
|
1
|
2
|
3
|
Source
Treatment Guide 13
CME/CPD
0.25 hours
Purchase price
10
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General information
| Case Type | |
|---|---|
| Jaw | - |
| Area | - |
| # of Teeth | - |
| # of Implants | - |
| Type of Implants | - |
| Attachment | - |
| Bone Augmentation | - |
|---|---|
| Augmentation Materials | - |
| Guided Surgery | - |
| Soft Tissue Grafting | - |
| Abutment Type | - |
| Prosthesis Type | - |
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 | - |
|---|---|
| Defining Characteristics | - |
| Modality | - |
| Placement Protocol | - |
| Tooth Site | - |
| Socket Morphology | - |
| Socket Integrity | - |
| Bone Volume | - |
| Anatomic Risk | - |
| Esthetic Risk | - |
| Complexity | |
| Risk of Complications | - |
Prosthodontic SAC classification
| SAC Level | - |
|---|---|
| Defining Characteristics | - |
| Loading Protocol | - |
| Retention | - |
| Maxillomandibular Relationship | - |
| Mesio-Distal Space | - |
| Inter-Arch Distance | - |
| Bruxism | - |
| Esthetic Risk | - |
| Provisional Implant-Supported Prosthesis | - |
| Interim Prosthesis during Healing | - |
| Occlusion/Articulation | - |
| Occlusal Scheme/Issues | - |
Surgical SAC Modifiers
| Periodontal Status | - |
|---|
Prosthodontic SAC Modifiers
| Soft Tissue Contour and Volume | - |
|---|
General SAC Modifiers
| Oral Hygiene and Compliance | - |
|---|---|
| Access | - |
| Craniofacial/Skeletal Growth | - |
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