2 The Determinants of the SAC Classification
A. Dawson, S.Chen
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.
|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|