Rehabilitating an Edentulous Maxilla with a Conventional Removable Denture and an Edentulous Mandible with a Fixed Dental Prosthesis Using s-CAIS - Clinical Case Report - Home

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Clinical Case Report

Rehabilitating an Edentulous Maxilla with a Conventional Removable Denture and an Edentulous Mandible with a Fixed Dental Prosthesis Using s-CAIS

Wei-Shao Lin, Waldemar Daudt Polido, Jyme Rae Charette, Dean Morton

This case describes a partial digital workflow in the treatment of a patient with a terminal dentition. It features virtual planning of static computer-aided implant surgery (s-CAIS) and CAD/CAM interim prostheses.

A 72-year-old male patient was referred to the prosthodontic clinic for possible implant treatment. He presented with a partially edentulous maxilla and mandible. The clinical and radiographic examination showed generalized chronic severe periodontitis with tooth mobility, dental caries, and direct composite restorations in three teeth. Pre-treatment periapical and panoramic radiographs revealed horizontal bone loss associated with all remaining teeth and vertical bone loss associated with the anterior teeth and confirmed the presence of generalized carious lesions.

Surgical SAC classification: Complex
Prosthodontic SAC classification: Complex

Source: Treatment Guide 11
Purchase price: 10 Academy Coins
CPD/CME: 0.25 hours

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General information

Case Type
Jaw	Mandible
Area	Full-Arch
# of Teeth	-
# of Implants	6
Type of Implants	One-Piece
Attachment	One-Piece

Bone Augmentation	No
Augmentation Materials	-
Guided Surgery	Yes
Soft Tissue Grafting	-
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	Fully edentulous lower jaw to be rehabilitated with two or more implants
Modality	4 or more implants, immediate loading
Placement Protocol	-
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	High
Risk of Complications	Low

Prosthodontic SAC classification

SAC Level	Complex
Defining Characteristics	Fully edentulous lower jaw to be rehabilitated with an implant-borne fixed dental prosthesis
Loading Protocol	Immediate
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	History of periodontitis or genetic predisposition

Prosthodontic SAC Modifiers

Soft Tissue Contour and Volume	Ideal

General SAC Modifiers

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

Publication date: Apr 26, 2022 Last review date: Apr 19, 2022 Next review date: Apr 19, 2025

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