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Clinical Case Report

Connective-Tissue Graft to Augment the Buccal Tissue for a Bone-Level Implant at an Upper Incisor Site

Eduardo R Lorenzana

Deficiencies in soft-tissue position and volume can negatively impact the emergence profile and contour of the final implant-supported restoration. This is a clinical case from Eduardo Lorenzana and Kurt Riewe that demonstrates the application of a connective tissue graft to augment the buccal soft tissue profile on a bone-level implant in the esthetic zone.

Surgical SAC classification
Advanced
Prosthodontic SAC classification
Complex
Source
Treatment Guide 12
Purchase price
10 Academy Coins
CPD/CME
0.25 hours

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General information

Case Type
Jaw Maxilla
Area Anterior
# of Teeth 1
# of Implants 1
Type of Implants Reduced-Diameter|Two-Piece
Attachment Reduced-Diameter|Two-Piece
Bone Augmentation No
Augmentation Materials -
Guided Surgery -
Soft Tissue Grafting Staged
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 Horizontally and vertically sufficient
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 Slightly compromised

General SAC Modifiers

Oral Hygiene and Compliance Good
Access Adequate
Craniofacial/Skeletal Growth Completed
Publication date: Mar 25, 2023 Last review date: Mar 18, 2023 Next review date: Mar 18, 2026

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