Implant soft tissue Dehiscence coverage Esthetic Score (IDES): A pilot within‐ and between‐rater analysis of consistency in objective and subjective scores

Abstract

Objectives To introduce an esthetic index for assessing the outcomes of peri‐implant soft tissue dehiscence/deficiency (PSTD) coverage and test its within‐ and between‐reviewer reliability. Materials and Methods Photographs of 51 single PSTDs at baseline and after treatment were provided to four periodontists from three centers. The examiners were asked to rate each case at two timepoints with the Implant soft tissue Dehiscence/deficiency coverage Esthetic Score (IDES) that involved the evaluation of the post‐treatment level of the soft tissue margin, peri‐implant papillae height, mucosa color, and mucosa appearance (summing up to a total score of 10). Variance components analysis was conducted using multilevel regression fit in a Bayesian framework for obtaining uncertainty intervals for fractional variance contributions and intraclass correlation values (ICC) of the IDES, and for each of its four clinical variables. Results Regression models showed reproducible esthetic evaluation among the examiners (inter‐reliability) and negligible intra‐reviewer variability (assessment of the same case at different timepoints). The ICC for the variability in the assessment of the overall IDES was 0.86, and for the individual components ranged from 0.78 to 0.87. Additionally, there was a strong similarity between the raters’ IDES values, and their subjective esthetic response, by the same raters. Conclusion The IDES showed persistent judgment among the 4 reviewers, and only a slight intra‐reviewer variability across timepoints. Within its limitations, this study suggests that the proposed novel score can be a reliable tool for evaluating the esthetic outcomes of PSTD coverage, which can aid in standardization of esthetic assessments following the treatment of a PSTD.

Non‐submerged reconstructive approach for peri‐implantitis osseous defect with removal of implant crowns: One‐year outcomes of a prospective case series study

“…Considering this rise and popularity in dental implant treatment, it is crucial to acknowledge and study the complications that may accompany these procedures. These can include the onset of peri‐implant diseases that can eventually lead to the loss of the implant itself, 3–7 or esthetic challenges in the presence of implant health such as the occurrence of peri‐implant soft tissue dehiscence/deficiencies 8–11 …”

Effectiveness of soft tissue augmentation procedures for coverage of buccal soft tissue dehiscence around dental implants: A systematic review

“…When focusing on esthetics evaluation, Zucchelli et al (2018) and Roccuzzo et al (2019) obtained at the 5‐year follow‐up good results and reported high patients´ satisfaction, but a comparison is difficult to make because both studies (Roccuzzo et al, 2019; Zucchelli et al, 2018) used a different evaluation scale VAS vs. pink and white esthetics score (PES/WES) (Belser et al, 2009; Fürhauser et al, 2005). For comparable and unified esthetic evaluation of BSTD coverage, Zucchelli et al (2021) developed the implant soft tissue dehiscence coverage Esthetic Score (IDES). The IDES involved four clinical variables: post‐treatment level of the soft tissue margin, peri‐implant papillae height, mucosa color, and mucosa appearance.…”

“…For comparable and unified esthetic evaluation of BSTD coverage,Zucchelli et al (2021) developed the implant soft tissue dehiscence coverage Esthetic Score (IDES). The IDES involved four clinical variables: post-treatment level of the soft tissue margin, peri-implant papillae height, mucosa color, and mucosa appearance.IDES seems to be a good approach for the standardized evaluation of esthetic assessments following BSTD coverage of implantsupported single crowns bounded by two natural teeth and would allow comparison of the esthetic outcome of different BSTD augmentation procedures.The acquisition of long-term data and the control of peri-implant health with tailored supportive periodontal therapy (STP) requires the measurement of clinical parameters during the follow-up period.Both studies(Zucchelli et al, 2013 andRoccuzzo et al, 2014) documented the progression of clinical parameters and were able to show a significant increase in CAL, KT (Zucchelli et al, 2013), and PPD TA B L E 3 Secondary outcomes Study Significant differences and correlations of secondary outcome(s) Burkhardt et al () STT: positive relation between the flap thickness and mean percentage of coverage of BSTD Anderson et al (2014) test group Wound healing more adverse with an ADM Increase of mucosal phenotype (p < .001) Mucosal phenotype correlated negatively with the distance from the crown to the gingival margin (p < .05) → the longer the crown, the thinner the phenotype Anderson et al (2014)…”

Etiology and Treatment of Peri-Implant Soft Tissue Dehiscences: A Narrative Review

“…In addition, among studies, different reference points to evaluate the peri-implant recession, as well as various indices for the assessment of the aesthetic outcome, have been used. Therefore, direct comparison of the clinical results is not always easy or meaningful [8,12]. In order to overcome this problem in future studies, Zucchelli et al introduced a new Implant soft tissue Dehiscence coverage Esthetic Score (IDES) for a more objective evaluation of the treatment outcome that incorporates and standardizes both clinical and aesthetics outcomes, as mentioned above [8].…”

“…The facial contour and the level of the soft tissue margin are significant variables of these indices [5][6][7]. Recently, Zucchelli et al introduced a new index (IDES) specifically for PSTD, in which the evaluation begins at least six months after the surgical attempts for coverage [8]. Specifically, four parameters are evaluated, which are the level of the soft tissue margin (STM), the peri-implant papillae height (PPH) compared with the homologous tooth, the peri-implant mucosa color, and the peri-implant mucosa appearance (PMA).…”