“ABCD” Implant Classification: A Comprehensive Philosophy for Treatment Planning in Completely Edentulous Arches
A thorough and precise treatment plan that considers various factors such as age, availability of bone, interarch space for prosthesis design, smile line, lip support, patient desires, and economics is a necessity before implant surgery. Many previous classification systems for treatment planning in edentulous situations tend to focus on only a certain parameter such as esthetics, or available bone volume, or are specifically designed for the maxilla or mandible. The authors have proposed a simplified and universal ABCD classification that uses the 4 vital parameters of age, bone volume, cosmetic display, and degree of resorption to create an algorithm that satisfies the treatment needs of every patient. Various permutations of the 4 parameters can be used to arrive at a solution that streamlines the further phases of the rehabilitative process. The aim of the present article is to provide a science-driven approach to understand a patient's individual needs with careful attention to the interplay of all the aforementioned factors in the decision-making process.

Figure 1. Interarch space. Figure 2. Preoperative orthopantomogram, case 1. Figure 3. Postextraction profile view. Figure 4. Maxillary arch with well-distributed implant positions to avoid cantilevers.

Figure 5. Mandibular arch with optimum implant distribution. Figure 6. Final prosthesis in maximum intercuspation. Figure 7. Profile view of final prosthesis. Figure 8. orthopantomogram of final prosthesis.

Figure 9. Preoperative profile view: case 2. Figure 10. Preoperative maxillary occlusal view. Figure 11. Preoperative orthopantomogram with radiographic markers. Figure 12. Two tilted and two axially placed implants to avoid advanced sinus grafting procedures. Figure 13. Measurement of interarch space. Figure 14. Final prosthesis with customized pink zone.

Figure 15. Final prosthesis in maximum intercuspation. Figure 16. Profile view of final prosthesis. Figure 17. Postoperative radiograph of final prosthesis. Figure 18. Bone zones.
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