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Clinical Case Report

Replacing a Mandibular Denture with a Full-Arch Implant-Supported Mandibular Fixed Dental Prosthesis

Panos Papaspyridakos

This case describes an all-digital approach to a common patient complaint: dissatisfaction with denture stability while chewing. A 68-year-old male patient with a mandibular complete denture opposing a full-arch maxillary provisional fixed dental prosthesis (FDP) presented for an implant consultation. His medical history was non-contributory, and there was no contraindication to dental implant treatment.

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

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General information

Case Type
Jaw Mandible
Area Full-Arch
# of Teeth -
# of Implants 5
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 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 Low
Complexity High
Risk of Complications Low

Prosthodontic SAC classification

SAC Level Straightforward
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 Low
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 -

General SAC Modifiers

Oral Hygiene and Compliance Sufficient
Access Adequate
Craniofacial/Skeletal Growth Completed
Publication date: Jul 9, 2021 Last review date: Jul 2, 2023 Next review date: Jul 2, 2026

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