Replacement of a Compromised Upper Right Central Incisor: Hard- and Soft-tissue Augmentation, Late Placement of an RC Bone Level Implant - Clinical Case Report - Home

Home

Case

Clinical Case Report

Replacement of a Compromised Upper Right Central Incisor: Hard- and Soft-tissue Augmentation, Late Placement of an RC Bone Level Implant

Paolo Casentini

A 36-year-old male patient with a compromised maxillary central incisor was referred by his general dentist for consultation. The patient’s chief complaints were the gradual debonding of a temporary crown on the right central incisor and unsatisfactory esthetics due to an increasing diastema between the right central and lateral incisors. The patient reported a traumatic event some years previously, when a crown had been placed after root-canal treatment. The referring dentist wanted to provide a new crown restoration, but was concerned about the condition of the residual root. Anamnesis was negative for any other dental or periodontal pathology in the remaining dentition. The patient reported taking no medications: He was a smoker (10 to 15 cigs/day) and had realistic esthetic expectations.

Surgical SAC classification: Complex
Prosthodontic SAC classification: Advanced

Source: Treatment Guide 10
Purchase price: 10 Academy Coins
CPD/CME: 0.25 hours

Recommended content

Replacement of an Upper Right Central Incisor with a Root Fracture, Early Placement of an RC Bone Level Implant, Variobase Abutment

Clinical Case Report
Replacement of an Upper Right Central Incisor with Root Resorption: Ridge Preservation, Early Placement of an RC Bone Level Implant

Clinical Case Report
Replacement of a Failing Upper Right Central Incisor, Ridge Preservation and Late Placement of a NC Bone Level Implant

Clinical Case Report
Replacement of a Missing Upper Left Central Incisor, Late Placement of an RC Bone Level Implant and Adjacent Tooth Restoration

Clinical Case Report

General information

Case Type	Single-Tooth Space
Jaw	Maxilla
Area	Anterior
# of Teeth	1
# of Implants	1
Type of Implants	Two-Piece
Attachment	Two-Piece

Bone Augmentation	Horizontal\|Simultaneous\|Staged
Augmentation Materials	Xenogenous\|Membrane
Guided Surgery	No
Soft Tissue Grafting	Simultaneous
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	One missing tooth to be replaced by an implant-borne prosthesis
Modality	-
Placement Protocol	Early or late implant placement
Tooth Site	-
Socket Morphology	-
Socket Integrity	-
Bone Volume	Deficient horizontally, requiring prior grafting
Anatomic Risk	Low
Esthetic Risk	Medium
Complexity	Moderate
Risk of Complications	Moderate

Prosthodontic SAC classification

SAC Level	Advanced
Defining Characteristics	One missing tooth to be replaced by an implant-borne crown
Loading Protocol	Conventional or early
Retention	Screw-retained Screw-retained
Maxillomandibular Relationship	Angle Class I and III
Mesio-Distal Space	Symmetry +/- 1 mm of contra-lateral tooth
Inter-Arch Distance	-
Bruxism	-
Esthetic Risk	Medium
Provisional Implant-Supported Prosthesis	Prosthodontic margin > 3 mm apical to mucosal margin Prosthodontic margin > 3 mm apical to mucosal margin
Interim Prosthesis during Healing	Removable Removable
Occlusion/Articulation	-
Occlusal Scheme/Issues	-

Surgical SAC Modifiers

Periodontal Status	Healthy

Prosthodontic SAC Modifiers

Soft Tissue Contour and Volume	Slightly compromised

General SAC Modifiers

Oral Hygiene and Compliance	Sufficient
Access	Adequate
Craniofacial/Skeletal Growth	Completed

Publication date: Nov 7, 2017 Last review date: Oct 30, 2022 Next review date: Oct 30, 2025

ITI QR code Mvc

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