Free excerpt - SAC Classification in Implant Dentistry

W. MARTIN, A. DAWSON, W. D. POLIDO

Prosthodontic classification

still limited. Fortunately, an internal reinforcement of the denture through the cast metal framework and a horizon- tal offset between the attachment and opposing canine allowed all components to be accommodated without any fractures or pronounced esthetic compromise. A fourth factor scored as a high risk was the role of the planned single implant in the maxillary right canine site to provide part of the anterior guidance (Figure 5). This ultimately elevated the prosthodontic classification to a high level. With the strategic placement of the implant seen in Figures 6 and 7, the aimwas for the partial denture to be part of a mutually protected scheme with anterior canine lifts and even incisal rise; the latter is seen in Figure 8.

Among the prosthodontic modifying factors, four factors were identified as potential concerns: Three medium-­ rated risk factors were identified (the anticipated minimal prosthetic volume, the interocclusal space at the planned implant site, and the ongoing mechanical and technical complications that might arise from these). Figure 6 shows the close relationship between the mandibular right ca- nine and the opposing overdenture abutment. The im- plant was placed further apically to provide vertical flexi- bility, but a decision was made not to attempt to also move the level of the hard and soft tissues of the adjacent resid- ual ridge further apically. The prosthetic volume and inter- occlusal clearance for the stud attachment was, therefore,

Fig 6. The close relationship between the mandibular right canine and the opposing ridge was evident from the outset. The implant was placed further apically to provide vertical flexibility. A decision was made not to move the level of the hard and soft tissues of the adjacent residual ridge further apically, and the prosthetic volume and interocclusal clearance for the stud attachment was therefore still limited.

Fig 5. In this case, the keratinized tissue outcome was a 2-mm band that has remained stable for 7 years.

Fig 7. The strategic position from an occlusal perspective of the implant placed in the maxillary right canine site is evident in the clinical image here. The plan was therefore for the implant to be directly involved in enabling the anterior denture saddle to provide dynamic anterior guidance.

Fig 8. The maxillary partial denture is able to provide anterior guidance here demonstrated in protrusion by even incisal rise.

The SAC Classification in Implant Dentistry

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