Case

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Clinical Case Report

Immediate Placement of an Implant in a Maxillary Right Central Incisor Site

Jay Robert Beagle

A 30-year-old female patient was referred to the office for the treatment of tooth 11. Her chief concern at the initial visit was to inquire, “Why is my tooth pink?” Upon clinical examination, it was determined that tooth 11 had a previous history of trauma and that the clinical crown had become noticeably pink in color as a result of internal resorption. This diagnosis was confirmed radiographically, indicating a large radiolucency involving the central and distal portions of the clinical crown. It was determined that restoration of this tooth was not possible, and that extraction was indicated. The presence of a mid-line diastema, which the patient wanted to reproduce, directed the treatment plan for tooth replacement utilizing a dental implant.

Surgical SAC classification
Complex
Prosthodontic SAC classification
Advanced
Source
Treatment Guide 3
Purchase price
10 Academy Coins
CPD/CME
0.25 hours

Recommended content

General information

Case Type Single-Tooth Space
Jaw Maxilla
Area Anterior
# of Teeth 1
# of Implants 1
Type of Implants One-Piece|Reduced-Diameter
Attachment One-Piece|Reduced-Diameter
Bone Augmentation Horizontal|Simultaneous
Augmentation Materials Autogenous chips|Membrane
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 One missing tooth to be replaced by an implant-borne crown
Modality -
Placement Protocol Immediate implant placement
Tooth Site Maxillary incisor or canine
Socket Morphology Single-root socket
Socket Integrity Sufficient, with intact bone walls
Bone Volume Sufficient, with intact walls
Anatomic Risk Low
Esthetic Risk High
Complexity Moderate
Risk of Complications High

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 Asymmetry greater than 1 mm
Inter-Arch Distance -
Bruxism -
Esthetic Risk High
Provisional Implant-Supported Prosthesis Prosthodontic margin < 3 mm apical to mucosal margin Prosthodontic margin < 3 mm apical to mucosal margin
Interim Prosthesis during Healing - -
Occlusion/Articulation -
Occlusal Scheme/Issues -

Surgical SAC Modifiers

Periodontal Status Healthy

Prosthodontic SAC Modifiers

Soft Tissue Contour and Volume Ideal

General SAC Modifiers

Oral Hygiene and Compliance Good
Access Adequate
Craniofacial/Skeletal Growth Completed
Publication date: Jan 11, 2015 Last review date: Apr 10, 2022 Next review date: Apr 10, 2025

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