Esthetic evaluation of implant-supported single crowns: a comparison of objective and patient-reported outcomes

Abstract

BackgroundThis study investigated objective and patient-reported esthetic outcomes and their correlation for single-tooth implant restorations in the maxillary anterior region.MethodsNineteen patients were included. Gingival biotypes and smile lines were evaluated. Esthetic evaluation was performed according to the pink and white esthetic scores (PES and WES). Patients rated their satisfaction regarding the implant treatment using a subjective outcome questionnaire and a 10-cm visual analogue scale (VAS).ResultsThe mean PES and WES were 10.7 (range 5–13, SD ± 2.24) and 8.6 (range 8–10, SD ± 0.60), respectively. The overall mean VAS was 8.54 ± 0.36 (range 3.8–9.8). No significant correlation was found between VAS and PES or WES (p = 0.475, p = 0.984, respectively). PES and WES scores for gingival biotypes failed to show any statistically significant difference (p = 0.701, p = 0.831). There was a significant negative correlation between the smile line and VAS; indicating that patients with lower smile lines expressed higher patient satisfaction (p = .001).ConclusionsProfessionally reported esthetic outcomes (PES and WES results) may not correlate with patient-reported outcomes. Smile line is a significant factor in patient satisfaction, which should be evaluated thoroughly prior to implant placement in the anterior maxilla.

Esthetic outcome and oral health-related quality of life after restoration with single anterior maxillary implants

“…The esthetic is subjective and should be evaluated by clinician objectively. Previous studies have reported relation between the objective evaluation by clinician and subjective evaluation by patients 3,6,8,17,19,27,28 .…”

“…Recent advances in osteointegration, high survival rates and success have increased the reputation of implant treatments 1,2 . Although implant treatment is well-established and successful, it is not a sufficient perspective to evaluate only in terms of osteointegration 3 . While replacing a single missing tooth in the anterior maxilla with an implant, clinicians should not only rebuild function but also provide the esthetics 4 .…”

Variations in Soft and Hard Tissues following Immediate Implant Placement versus Delayed Implant Placement following Socket Preservation in the Maxillary Esthetic Region: A Randomized Controlled Clinical Trial

“…One of the key factors in the success of implant therapy, especially in the maxillary esthetic region is patient satisfaction; hence, a visual analogue scale was used to analyse patient's satisfaction for esthetics and pain. A VAS value of 7-8 has been described to represent good esthetic results, while higher values 9-10 indicate optimum implant esthetics [ 14 , 24 ]. Case selection was carefully done limiting to include teeth which are non-restorable, and patients with type 1 extraction sockets alone were included to ensure intact bony wall at the time of implant placement to prevent any variations in assessment of CBT that could occur if patients with varying degrees of resorption of the buccal bony wall were included.…”

“…Even though the mean difference was only 0.2 mm, it presents a lot of clinical relevance as the buccal wall thickness is <1 mm in the maxillary esthetic region [ 31 ] and it will make a huge difference in the soft tissue alterations as observed in our study. The insertion of bovine bone granules and autogenous bone in the gap between the implant and the bony socket wall could have successfully prevented resorption of the buccal bundle bone in the IIP group [ 14 , 24 ]. However, there was an increased reduction in the thickness of buccal bone in the DIP group as a result of remodelling resorption that would have occurred in the four-month interval between socket preservation and implant placement.…”

“…However, the superiority of IIP compared to delayed implant placement (DIP) following socket preservation has not been established so far as there are only limited human studies comparing both these techniques in the maxillary esthetic region. Moreover, patient-reported outcomes (PROs) are now regarded as a fundamental measure of therapeutic success [ 13 , 14 ]. However, current literature reveals only a limited number of studies reporting on patient-centered outcomes in addition to objective evaluations of implant-supported rehabilitations in the anterior maxilla.…”