2 The Determinants of the SAC Classification
A. Dawson, S.Chen
2.1 Definitions
Process: The implant dentistry “process” is defined as the full range of issues pertaining to assessment, planning, management of treatment, and subsequent maintenance of the implant and prosthetic reconstruction; it does not merely refer to the clinical treatment procedures that are involved.
Normative: In this context, “normative” relates to the classification that conforms to the norm, or standard, for a given clinical situation in implant dentistry. The normative classification relates to the most likely representation of the classification of a case. The normative classification may alter as a result of modifying factors and/or complications.
Timing of implant placement: A number of different classifications have been used to describe the timing of implant placement after tooth extraction. In this book, the classification detailed by Chen and Buser (2008), which is a modification of the classification proposed by Hämmerle et al. (2004), will be used. This classification is summarized in Table 1.
| Classification | Descriptive Terminology | Period after Tooth Extraction | Desired Clinical Situation at Implant Placement |
| Type 1 | Immediate placement | Immediately following extraction | Post-extraction site with no healing of bone or soft tissues |
| Type 2 | Early placement with soft-tissue healing | Typically 4 to 8 weeks | Post-extraction site with healed soft tissue but without significant bone healing |
| Type 3 | Early placement with partial bone healing | Typically 12 to 16 weeks | Post-extraction site with healed soft tissues and with significant bone healing |
| Type 4 | Late placement | Typically 6 months or longer | Fully healed post-extraction site |
Implant loading protocol: In discussions relating to the systems for loading implants after implant placement, the definitions used by Cochran et al. (2004) will be used. These are summarized in Table 2.
| Loading Protocol | Definition |
| Immediate restoration | A restoration is inserted within 48 hours of implant placement, but not in occlusion with the opposing dentition |
| Immediate loading | A restoration is placed in occlusion with the opposing dentition within 48 hours of implant placement |
| Conventional loading | The prosthesis is attached after a healing period of 3 to 6 months |
| Early loading | A restoration in contact with the opposing dentition is placed at least 48 hours after implant placement but not later than 3 months afterwards |
| Delayed Loading | The prosthesis is attached in a procedure that takes place some time later than the conventional healing period of 3 to 6 months |
2.2 Assumptions
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