Esthetic Evaluation and Acceptability of Different Hole Designs on Implant Crowns from the Perspective of Patients and Dentists in China

Abstract

Purpose Abutment access hole on dental implant crowns may facilitate crown retrieval and reduce cement overflow but present esthetic obstacle for patients. This study aimed to investigate the esthetic evaluation and acceptability of implant crowns with different hole designs from the perspective of patients and dentists. Materials and Methods Anterior and posterior implant zirconia crowns were fabricated into three types: no hole (NH), 1 mm micro hole (MH), and 2.5 mm regular hole (RH). The NH crown was set as the control, and the anterior and posterior crowns with MH and RH were evaluated. The subjects, who were recruited randomly, were comprised of lay patients (n=60) and professional dentists (n=30). All subjects were invited to evaluate the esthetic performance of MH and RH crowns on a Visual Analog Scale (VAS), rate them from 0 to 10, state their acceptability of these crowns, and label them as acceptable and unacceptable. Results The ANOVA analysis of the VAS esthetic evaluation showed that the size of the hole, the position of the teeth, and the professional background of the subject significantly and independently affected esthetic perception. Crowns with MH in the posterior position had higher esthetic scores and acceptability compared with crowns with RH in the anterior position, and dentists tended to show higher acceptance and better esthetic rating for crowns with holes compared with lay patients. Conclusion The hypothesis that patients and dentists hold similar esthetic evaluations or acceptability towards implant crown hole designs was rejected. Lay patients had a lower tolerance for venting holes than dentists. Crowns with 1 mm micro holes were more recommendable than crowns with regular abutment access holes from the point of view of satisfying patients’ esthetic needs.

Evaluation of Patient’s Aesthetic Satisfaction after the Cementation of the Porcelain Fused to Metal Crown

“…Hence, with age mental functions become less nimble and flexible along with memory, which influences the aesthetic choices and satisfaction. According to Ahlholm et al, Young people show greater interest in whiter teeth and beautiful smile compared to old age 19 . Similar findings were presented by Alkhatib et al, they showed age had an impact on dissatisfaction with dental aesthetics; however, the level of acceptability of aesthetic changes in elderly is significantly higher than in younger patients for tooth colored restoration 18 .…”

“…This indicates that the higher education increases awareness for a person and desire for better esthetic restorations. Studies have shown greater acceptability for anterior zirconia crown among the higher educated people [19][20][21] . Hence, these findings indicate that higher self-satisfaction for dental aesthetics are observed in participants with higher academic titles.…”

Changes of dental anxiety, aesthetic perception and oral health-related quality of life related to influencing factors of patients’ demographics after anterior implant treatment: a prospective study

“…Therefore, doubled scores of the aesthetic perception after definitive prosthesis placement confirmed the positive effect of anterior implant treatment on the patient-reported overall outcomes. A definitive screw-retained porcelain-fused-to-metal (PFM) or a CAD/CAM zirconia restoration were performed with lingual screw access hole as invisible as possible, which satisfied patients’ aesthetic needs [ 25 ].…”

Should the vent hole of posterior implant crowns be placed on the lateral surface? An in vitro study of the hydrodynamic feature of cement extrusion and retention ability

“…Cement-retained crowns have the advantages of lower costs and easy passive fit between implant components. Although cement-retained implant crowns are favored by dentists for their low cost and easy handling, their disadvantage is obvious: it is difficult and sometimes impossible to avoid excessive subgingival cement residue, which can lead to peri-implant disease [ 11 , 18 ]. Due to the deleterious effect of the extruded cement residue, attempts have been made to find methods to eliminate these drawbacks, such as opening holes of different diameters on the crown [ 19 , 20 ], increasing the unfilled space of the abutment screw access hole [ 19 ], loading a precise amount of cement on the crown [ 21 ], placing the crown’s margin supragingivally [ 22 ], using polytetrafluoroethylene tape or a rubber dam as a barrier [ 23 , 24 ], and applying customized abutment analogs prior to final cementing to obtain a customized cement film thickness [ 25 ].…”

“…composite resin) [ 27 ] and may cause deterioration of the fracture strength of the zirconia crown [ 16 ]. Nevertheless, a previous study showed that patients and dentists have different esthetic attitudes toward implant crowns with holes as well as different acceptability [ 18 ]. While dentists generally take holes on the implant crown for granted, most patients may not be aware that they would have holes on the implant crown, especially on the occlusal surface, when they begin treatment.…”