Soft Tissue Augmentation before Implant Placement in an Area of High Surgical and Esthetic Risk - Clinical Case Report - Home

Home

Case

Clinical Case Report

Soft Tissue Augmentation before Implant Placement in an Area of High Surgical and Esthetic Risk

Xian Jun Edwin Goh, Sheralyn Quek

The Straightforward, Advanced and Complex (SAC) classification in implant dentistry was introduced following an International Team for Implantology (ITI) Consensus conference held in 2007 (Dawson 2009). The classification aimed to assist clinicians in evaluating the difficulty of cases, and serve as a tool for case selection and treatment planning. Individual cases can be classified into straightforward, advanced, or complex in both surgical and restorative aspects depending on their associated risk factors and complexity. The aim of this article is to illustrate how the SAC classification was used to identify a case of high surgical and esthetic risk, the steps undertaken to minimize potential complications, and its successful long-term follow-up.

Surgical SAC classification: Advanced
Prosthodontic SAC classification: Complex

Source: User Case
Purchase price: 10 Academy Coins
CPD/CME: 0.15 hours

Recommended content

Replacement of Multiple Teeth in a Partially Dentate Posterior Mandible with a Fixed Dental Prosthesis Using a Flapless Approach

Clinical Case Report
Management of Postoperative Infection Following Implant Placement

Clinical Case Report
Central Incisor Fracture

Clinical Case Report
Missing Maxillary Central Incisor, Single Implant Replacement with Adjacent Tooth Restoration

Clinical Case Report

General information

Case Type
Jaw	Maxilla
Area	Anterior
# of Teeth	1
# of Implants	1
Type of Implants	One-Piece
Attachment	One-Piece

Bone Augmentation	Simultaneous
Augmentation Materials	Xenogenous
Guided Surgery	-
Soft Tissue Grafting	Yes
Abutment Type	-
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	Advanced
Defining Characteristics	One missing tooth to be replaced by an implant-borne prosthesis
Modality	Modality
Placement Protocol	Early or late implant placement
Tooth Site	Tooth site
Socket Morphology	Socket morphology
Socket Integrity	Socket integrity
Bone Volume	Deficient horizontally, allowing simultaneous augumentation
Anatomic Risk	Low
Esthetic Risk	High
Complexity	Low
Risk of Complications	Low

Prosthodontic SAC classification

SAC Level	Complex
Defining Characteristics	One missing tooth to be replaced by an implant-borne crown
Loading Protocol	Conventional or early
Retention	-
Maxillomandibular Relationship	-
Mesio-Distal Space	-
Inter-Arch Distance	-
Bruxism	-
Esthetic Risk	High
Provisional Implant-Supported Prosthesis	-
Interim Prosthesis during Healing	-
Occlusion/Articulation	-
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	Good
Access	Adequate
Craniofacial/Skeletal Growth	Completed

Publication date: Sep 26, 2022 Last review date: Sep 19, 2022 Next review date: Sep 19, 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