The SAC Classification in Implant Dentistry

Center for Implant Dentistry

Department of Oral and Maxillofacial Surgery

College of Dentistry

University of Florida

1395 Center Drive, Rm D7-6

Gainesville, Florida 32610

United States of America

Email: wmartin@dental.ufl.edu

Waldemar D. Polido, DDS, MS, PhD

Clinical Professor, Department of Oral and

Maxillofacial Surgery and Hospital Dentistry

Co-Director, Center for Implant, Esthetic and

Innovative Dentistry

Indiana University School of Dentistry

1121 W Michigan St, DS 109C

Indianapolis, Indiana 46202

United States of America

Email: wdpolido@iu.edu

Daniel Buser, DMD, Dr med dent

Professor Emeritus

University of Bern

Buser & Frei Center for Implantology

Werkgasse 2

3018 Bern

Switzerland

Email: danbuser@mac.com

Paolo Casentini, DDS, DMD

Private practice

Studio Dr Paolo Casentini

(Implantology, Oral Surgery, Periodontology, Esthetic Dentistry)

Via Anco Marzio 2

20123 Milano MI

Italy

Email: paolocasentini@fastwebnet.it

Vivianne Chappuis, PhD, DMD

Professor

Department of Oral Surgery and Stomatology

School of Dental Medicine

University of Bern

Freiburgstrasse 7

3010 Bern

Switzerland

Email: vivianne.chappuis@zmk.unibe.ch

Stephen Chen, MDSc, PhD

Faculty of Medicine, Dentistry and Health Sciences

Melbourne Dental School

The University of Melbourne

720 Swanston Street

Carlton, Victoria 3053

Australia

Email: schen@periomelbourne.com.au

Matteo Chiapasco, MD

Professor Unit of Oral Surgery

Department of Biomedical, Surgical, and Dental Sciences

University of Milan

Via della Commenda 10

20122 Milano MI

Italy

Email: matteo.chiapasco@unimi.it

Anthony J. Dickinson, OAM, BDSc, MSD, FRACDS

1564 Malvern Road

Glen Iris, Victoria 3146

Australia

Email: ajd1@i-pros.com.au

Luiz H. Gonzaga, DDS, MS

Clinical Associate Professor

Center for Implant Dentistry

Department of Oral and Maxillofacial Surgery

College of Dentistry

University of Florida

1395 Center Drive, Rm D7-6

Gainesville, Florida 32610-0434

United States of America

Email: lgonzaga@dental.ufl.edu

Stefan Keller Babotai, Dr sc nat

FERN Media Solutions GmbH

Weiherallee 11B

8610 Uster

Switzerland

Email: stefan.keller@fern.ch

Johannes Kleinheinz, MD, DDS Professor

Department of Cranio-Maxillofacial Surgery

University Hospital Münster

Albert-Schweitzer-Campus 1

48149 Münster

Germany

Email: johannes.kleinheinz@ukmuenster.de

Wei-Shao Lin, DDS, FACP, PhD

Associate Professor

Interim Chair, Department of Prosthodontics

Program Director, Advanced Education Program in Prosthodontics

Indiana University School of Dentistry

1121 W Michigan St, DS-S406

Indianapolis, Indiana 46202

United States of America

Email: weislin@iu.edu

Dean Morton, BDS, MS, FACP

Professor Department of Prosthodontics

Director, Center for Implant, Esthetic, and Innovative Dentistry

Indiana University School of Dentistry

1121 W Michigan St

Indianapolis, Indiana 46202

United States of America

Email: deamorto@iu.edu

Ali Murat Kökat, DDS, PhD

Prosthodontist

Private Practice

Valikonaǧı St 159/5

Nisantasi 34363 Sisli

Istanbul

Turkey

Email: alimurat@outlook.com

Mario Roccuzzo, DMD

Lecturer in Periodontology

Division of Maxillofacial Surgery

University of Turin

Corso Bramante 88

10126 Torino

Italy

and

Adjunct Clinical Assistant Professor

Department of Periodontics and Oral Medicine

University of Michigan

1011 N University Avenue

Ann Arbor, Michigan 48109-1078

United States of America

and

Private Practice Limited to Periodontology

Corso Tassoni 14

10143 Torino

Italy

Email: mroccuzzo@icloud.com

Charlotte Stilwell, DDS

Specialist Dental Services

94 Harley Street

London W1G 7HX

United Kingdom

Email: charlotte.stilwell@iti.org

Alejandro Treviño Santos, DDS, MSc

Postdoctoral and Research Division

Faculty of Dentistry

Department of Prosthodontics and Implantology

National Autonomous University of Mexico

Prolongación Reforma 1190

05349, Santa Fe

Ciudad de México

Mexico

Email: aletresan@hotmail.com

Daniel Wismeijer, PhD, DMD

Private Practice

Zutphensestraatweg 26

6955 AH Ellecom

Netherlands

Email: Danwismeijer@gmail.com

Chapter 1: Introduction to the Updated SAC Classification CHAPTER 1: Introduction to the Updated SAC Classification A. DAWSON, W. MARTIN, W. D. POLIDO

A. DAWSON, W. MARTIN, W. D. POLIDO

1.1 Introduction 1.1 Introduction Implant dentistry is an integral part of modern dental practice, providing a strong evidence-based option for the rehabilitation of partially and completely edentulous patients. Clinical and technologic advancements in this field have increased the level of confidence that clinicians have in this form of therapy and have also led to a broader base of incorporation into daily practice. What was once the domain of specialist practice is now a common treatment modality in many, if not most, general practices. This has increased the need for all clinicians involved with the field of implant dentistry, irrespective of specialty, to be able to provide therapy at an appropriate level of care. It has long been recognized that clinical situations present with different levels of difficulty and with different degrees of risk for esthetic, restorative, and surgical complications. Despite the advances in knowledge and improved techniques, implant dentistry is not free from risks of complications or suboptimal outcomes. Over the last decade, research in this field has increasingly provided information regarding the risks associated with this treatment option. The successful osseointegration of an implant is no longer the primary focus of treatment. Rather, the range of potential problems with implants and their related prostheses has come into sharper focus. It is in this environment that the SAC classification has evolved to assist practitioners in recognizing risk factors and providing appropriate levels of care.

1.2 Historical Background

1.3 The Review Team

1.4 Potential Roles for the SAC Classification

1.5 Using this Book

Chapter 2: The Rationale Behind the Updated SAC Classification

A. DAWSON, C. STILWELL

2.1 Definitions

2.2 Assumptions

2.3 Is the Clinician a Risk Factor?

2.3.1 Factors impacting the clinician as a risk factor

2.3.1.1 Experience

2.3.1.2 Training

2.3.1.3 Self-assessment of ability

2.3.1.4 Shared learning

2.3.1.5 Short training courses

2.3.1.6 Structured education and training

2.3.2 Reducing clinician-related risk

2.3.2.1 Recognizing “human factor” risks

2.3.2.2 Stress as a risk factor

2.3.2.3 Mitigating the human factor issues

2.3.2.4 Clinician risk factor in relation to other sources of risks

2.4 Classification Rationale

Chapter 3: Risks in Implant Dentistry

A. DAWSON, W. MARTIN, W. D. POLIDO

3.1 Principles of Risk Management

3.2 The SAC Classification as a Risk Management Tool

3.3 General Risks

A. DAWSON, J. KLEINHEINZ, A. MURAT KÖKAT, D. WISMEIJER

3.3.1 Patient medical factors