The SAC Classification in Implant Dentistry. Группа авторов
Consensus Conferences. Hämmerle and coworkers (Hämmerle et al, 2004) defined the timing of implant placement relative to the event of tooth removal in a site, relating this to healing events rather than a specific time frame. This classification is detailed in Table 1.
Table 1 Implant placement protocols (Hämmerle et al, 2004).
| Classification | Definition |
| Type 1 | Implant placement immediately following tooth extraction and as part of the same surgical procedure |
| Type 2 | Complete soft tissue coverage of the socket (typically 4 to 8 weeks) |
| Type 3 | Substantial clinical and/or radiographic bone fill of the socket (typically 12 to 16 weeks) |
| Type 4 | Healed site (typically more than 16 weeks) |
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Review article from the 3rd ITI Consensus Conference on the Placement of Implants in Extraction Sockets by Hämmerle and coworkers (2004). |
Implant loading protocols were also the subject of consensus conference reviews. At the Fourth ITI Consensus Conference, Weber and coworkers (Weber et al, 2009) defined the timing of implant loading relative to its placement. These descriptions are summarized in Table 2.
Table 2 Implant loading protocols (Weber et al, 2009).
| Classification | Definition |
| Conventional loading | Greater than 2 months subsequent to implant placement |
| Early loading | Between 1 week and 2 months subsequent to implant placement |
| Immediate loading | Earlier than 1 week subsequent to implant placement |
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Review article from the 4th ITI Consensus Conference on Loading Protocols by Weber and coworkers (2009). |
Most recently, the relationships between the timing of implant placement (relative to the time that the tooth in the placement site was extracted) and the timing of loading of the implant with a provisional or definitive prosthesis in partially dentate patients were addressed by Gallucci et al (Gallucci et al, 2018). The outcomes of this review, correlating the evidence for the various combinations of placement and loading protocol, are summarized in Table 3. Protocols that had multiple high-quality studies were deemed scientifically and clinically validated (SCV) and could be seen as suitable for routine use by appropriately trained and experienced clinicians. Clinically documented (CD) approaches had less support in the published literature but did possess reasonable long-term clinical documentation to allow their use in specific situations. Finally, clinically insufficiently documented (CID) protocols lacked sufficient scientific evidence and clinical documentation to be recommended for use. This review built on previous consensus meetings where definitions of the placement and loading protocols were developed.
Table 3 Summary of placement and loading protocols (Gallucci et al, 2018).
| Loading protocol | |||
| Immediate restoration/loading (Type A) | Early loading (Type B) | Conventional loading (Type C) | |
| Implant placement protocol | |||
| Immediate placement (Type 1) | Type 1A CD | Type 1B CD | Type 1C SCV |
| Early placement (Type 2–3) | Type 2–3A CID | Type 2–3B CID | Type 2–3C SCV |
| Late placement (Type 4) | Type 4A CD | Type 4B SCV | Type 4C SCV |
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Review article from the 6th ITI Consensus Conference on Implant Placement and Loading Protocols in Partially Edentulous Patients by Gallucci and coworkers (2018). |
Risk factors This term refers to any preexisting condition, treatment option, or material choice that may have an adverse effect on the outcome of treatment. These factors have the potential to influence the final SAC classification of a clinical situation.
2.2 Assumptions
This classification assumes that appropriate training, preparation, and care are devoted to the planning and implementation of treatment plans. No classification can adequately address cases or outcomes that deviate significantly from the norm. In addition, it is assumed that clinicians will be practicing within the bounds of their clinical competence and abilities. Thus, within each classification, the following general and specific assumptions are implied:
• Treatment will be provided in an appropriately equipped dental office with an appropriate aseptic technique.
• Adequate clinical and laboratory support is available.
• Patients’ medical conditions are appropriately addressed.
• The surgical procedures are planned and provided following recognized protocols.
• The prosthesis is designed, manufactured, and managed correctly.
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