Iliac-Crest Block for Vertical and Horizontal Space Filling in the Anterior Maxilla - Clinical Case Report - Home

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Clinical Case Report

Iliac-Crest Block for Vertical and Horizontal Space Filling in the Anterior Maxilla

Waldemar Daudt Polido, Joao Emilio Roehe Neto

A 31-year-old man presented to our clinic 30 days after a motor vehicle accident in which he had suffered a dentoalveolar fracture in the anterior maxilla, including avulsion of teeth 12 and 11 and luxation of tooth 21. He was first treated on the night of the accident in a small city hospital with no oral and maxillofacial surgeon on the staff. A wired retention had been applied and the teeth repositioned to the best of the clinicians’ abilities. When he first presented to our care, the patient showed extrusion of teeth 12 and 11 associated with gingival recession due to bone loss in the anterior maxilla, and the stainless steel wires were still present.

Surgical SAC classification: Complex
Prosthodontic SAC classification: Advanced

Purchase price: 10 Academy Coins
CPD/CME: 0.25 hours

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General information

Case Type	Short Space
Jaw	Maxilla
Area	Anterior
# of Teeth	3
# of Implants	3
Type of Implants	One-Piece\|Reduced-Diameter
Attachment	One-Piece\|Reduced-Diameter

Bone Augmentation	Horizontal\|Staged\|Vertical
Augmentation Materials	Autogenous chips\|Autogenous block(s)
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	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	High
Complexity	High
Risk of Complications	High

Prosthodontic SAC classification

SAC Level	Advanced
Defining Characteristics	Up to three missing teeth to be replaced with an implant-borne restoration or restorations
Loading Protocol	Conventional or early
Retention	Screw-retained, with 2 unsplinted implants Screw-retained, with 2 unsplinted implants
Maxillomandibular Relationship	-
Mesio-Distal Space	Adequate for the replacement of all missing teeth
Inter-Arch Distance	-
Bruxism	Absent
Esthetic Risk	High
Provisional Implant-Supported Prosthesis	- -
Interim Prosthesis during Healing	Removable Removable
Occlusion/Articulation	Harmonious
Occlusal Scheme/Issues	-

Surgical SAC Modifiers

Periodontal Status	Healthy

Prosthodontic SAC Modifiers

Soft Tissue Contour and Volume	Significantly deficient

General SAC Modifiers

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

Publication date: Oct 13, 2014 Last review date: Apr 10, 2022 Next review date: Apr 10, 2025

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