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Clinical Case Report

Replacing Three Mandibular Posterior Teeth with an Immediately Loaded Fixed Dental Prosthesis

Wiebe Dc Derksen

A 60-year-old healthy male patient presented with problems involving a fixed dental prosthesis (FDP) in the lower left quadrant. The bridge had de-cemented from abutment teeth 33 and 35; tooth 33 was decayed, and tooth 35 had little structure remaining. Since removing the FDP spanning sites 33 to 38 would have compromised function and raised esthetic concerns, the possibility of immediate implant placement and provisionalization was investigated.

Surgical SAC classification
Advanced
Prosthodontic SAC classification
Complex
Source
Treatment Guide 11
Purchase price
10 Academy Coins
CPD/CME
0.15 hours

Recommended content

General information

Case Type
Jaw Mandible
Area Posterior
# of Teeth 5
# of Implants 3
Type of Implants Two-Piece
Attachment Two-Piece
Bone Augmentation Horizontal|Simultaneous
Augmentation Materials -
Guided Surgery -
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 Advanced
Defining Characteristics More than three missing teeth to be replaced with an implant-borne prosthesis or prostheses
Modality Modality
Placement Protocol Immediate implant placement
Tooth Site Mandibular premolar, adjacent to mental foramen
Socket Morphology Single-root socket
Socket Integrity Damage to one or more bone walls
Bone Volume Damage to one or more socket walls
Anatomic Risk Low
Esthetic Risk High
Complexity Low
Risk of Complications Low

Prosthodontic SAC classification

SAC Level Complex
Defining Characteristics Up to three missing teeth to be replaced with an implant-borne restoration or restorations
Loading Protocol Immediate
Retention -
Maxillomandibular Relationship -
Mesio-Distal Space Anatomic space corresponding to the missing teeth +/- 1 mm
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 Ideal

General SAC Modifiers

Oral Hygiene and Compliance Sufficient
Access Adequate
Craniofacial/Skeletal Growth Completed
Publication date: Jun 29, 2021 Last review date: Jun 22, 2022 Next review date: Jun 22, 2025

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