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quarter 3
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2013
Fig. 1:
surgical classification of cases
in extended edentulous spaces in areas of low esthetic risk
Defining characteristics: More than 2 implants, span of more than 3 teeth
risk assessment:
Low
●
Moderate
●
High
●
1-Anatomic risk 2-Esthetic risk 3-complexity 4-Risk of Complication
normative
Bone Volume
1 2 3 4
Classification
Adjunctive procedures that may be required
Sufficient
● ●
●
●
Straight-
→
None
forward
Deficient horizontally,
●
●
● ●
Advanced
→
Simultaneous horizontal bone augmentation
allowing simultaneous
→
Low risk of complications for small defects; risk may increase for larger defects
grafting
→
Involvement of mental foramina in the mandible
→
Donor site morbidity
Deficient horizontally,
●
●
●
●
complex
→
Horizontal bone augmentation
requiring prior grafting
→
Involvement of the mental foramina in the mandible
→
Donor site morbidity
Deficient vertically,
●
●
● ●
complex
→
Risk to adjacent teeth
with or without a
→
Vertical and/or horizontal bone augmentation
horizontal defect
→
Involvement of the mental foramen and inferior alveolar nerve in the mandible
→
Sinus floor grafting
→
Donor site morbidity
aswe starttoemploybothcad/cam
and CBCT technologies into everyday
clinical dentistry, we lose perspective of
the clinical challenges that our patients
present with. We often jump at the
opportunity to treatment plan patients
— sometimes prematurely treatment
plan implants without consideration for
traditional implant protocols. Implant
dentistry has progressed to become the
standard of care for the rehabilitation of
fully and partially edentulous patients.
With technologies such as CBCT,
there has been a strong movement
of clinicians wanting to learn how to
provide implant therapy as part of their
everyday practice. The opportunity of
the clinicians to provide
implant therapy requires
a
fundamental
under-
standing of the treatment
The SAC Classification
in Implant Dentistry
A Categorization of Treatment Complexity
c a s e s t u d y
| | |
b y N e a l Pat e l , D . D . S .
I personally searched for a turnkey
system that would help me to treatment
plan patients for implant therapy. The
SAC method of classification simplifies
the evaluation of complexity in implant
dentistry from both the surgical and
restorative aspect of treatment. In partic-
ular, I have found the online version
of the ITI SAC method of classifica-
tion especially useful when patients are
presenting for their initial consultation
(available at
. Considering
that implant education often occurs at
the postgraduate level for many clini-
cians, at times these clinicians do not
readily understand how to identify and
categorize patient treatment complexity
and risk. Presenting the findings to
the patient using the SAC tool is key to
establishing appropriate expectations,
risks and benefits to patients prior to
being
recommended
to
patients.
Although patients prefer the “easy”
route, they deserve to understand their
options. One should consider an objec-
tive methodology for the classification
of patients based on their initial presen-
tation to define treatment options for
comprehensive and interdisciplinary
implant therapy (Fig. 1).
The SAC method of classification
was introduced by the International
Team for Implantology (ITI) to help
categorize treatment procedures into
three levels complexity: Straightfor-
ward, Advanced and Complex. The
rapid development of clinical techniques
and biomaterials in implant dentistry
has led to an expansion in the clinical
indications for implant dentistry and
now forms an integral part of everyday
dental practice.
