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Clinical Case Report

Oral Rehabilitation Aided by Digital Dentistry: Immediate Functional Loading with a Prefabricated Provisional Restoration

Alejandro Lanis

The author provides a step-by-step guide for meticulous planning and execution using a fully digital workflow. Of note, the maxillary rehabilitation was achieved in three phases using CAD/CAM technology: (1) PMMA provisional, fabricated prior to flapless guided implant placement and used to create the desired soft-tissue profile (2) PMMA definitive restoration prototype, used to confirm and perfect clinical details (3) Zirconia definitive restoration.

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

Recommended content

General information

Case Type Edentulous Maxilla
Jaw Maxilla and Mandible
Area Full-Arch|Posterior
# of Teeth -
# of Implants 12
Type of Implants Two-Piece
Attachment Two-Piece
Bone Augmentation No
Augmentation Materials -
Guided Surgery Yes
Soft Tissue Grafting -
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 Fully edentulous upper jaw to be rehabilitated with four or more implants
Modality 6+ implants with 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 High

Prosthodontic SAC classification

SAC Level Complex
Defining Characteristics Fully edentulous upper 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 Slightly compromised

General SAC Modifiers

Oral Hygiene and Compliance Insufficient
Access Adequate
Craniofacial/Skeletal Growth Completed
Publication date: Dec 2, 2021 Last review date: Nov 25, 2022 Next review date: Nov 25, 2025

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