J Adv Prosthodont.  2016 Oct;8(5):345-353. 10.4047/jap.2016.8.5.345.

Esthetic outcome for maxillary anterior single implants assessed by different dental specialists

• Al-Dosari
• Al-Rowis R
• Moslem F
• Alshehri F
• Ballo AM

• KMID: 2355438
• DOI: http://doi.org/10.4047/jap.2016.8.5.345

Abstract

PURPOSE
The aim of this study was to assess the esthetic outcome of maxillary anterior single implants by comparing the esthetic perception of dental professionals and patients.
MATERIALS AND METHODS
Twenty-three patients with single implants in the esthetic zone were enrolled in this study. Dentists of four different dental specialties (Three orthodontists, three oral surgeons, three prosthodontists, and three periodontists) evaluated the pink esthetic score (PES)/white esthetic score (WES) for 23 implant-supported single restorations. The satisfactions of the patients on the esthetic outcome of the treatment have been evaluated according to the visual analog scale (VAS).
RESULTS
The mean total PES/WES was 12.26 ± 4.76. The mean PES was 6.45 ± 2.78 and mean WES was 5.80 ± 2.82. There was a statistically significant difference among the different specialties for WES (P<.01) and Total PES/WES (P<.01). Prosthodontists were found to have assigned poorer ratings among the other specialties, while oral surgeons gave the higher ratings than periodontists, orthodontists, and prosthodontists.
CONCLUSION
Prosthodontists seemed to be stricter when assessing aesthetic outcome among other specialties. Moreover, a clear correlation existed between dentists' and patients' esthetic perception, thereby providing rationales for involving patients in the treatment plan to achieve higher levels of patient satisfaction.

Keyword

Perception of implant esthetics; Patient satisfaction; Single-tooth implants; Pink esthetic score/white esthetic score

MeSH Terms

Dental Implants, Single-Tooth
Dentists
Humans
Oral and Maxillofacial Surgeons
Orthodontists
Patient Satisfaction
Specialization*
Specialties, Dental
Visual Analog Scale

Figure

• 

  Fig. 1 Clinical photograph of implant-supported single-tooth restoration at the region of the left central incisor.

• 

  Fig. 2 Radiographic evaluation for implant-supported single-tooth restoration at the left central incisor location.

• 

  Fig. 3 Patient satisfaction based on the 13 questions.

• 

  Fig. 4 Correlation between the total pink esthetic score (PES)/white esthetic score (WES) and the visual analog scale (VAS).

Reference

1. Albrektsson T, Brånemark PI, Hansson HA, Lindström J. Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand. 1981; 52:155–170.

2. Stellingsma K, Bouma J, Stegenga B, Meijer HJ, Raghoebar GM. Satisfaction and psychosocial aspects of patients with an extremely resorbed mandible treated with implant-retained overdentures. A prospective, comparative study. Clin Oral Implants Res. 2003; 14:166–172.

3. Mombelli A, Lang NP. The diagnosis and treatment of peri-implantitis. Periodontol 2000. 1998; 17:63–76.

4. Papaspyridakos P, Chen CJ, Singh M, Weber HP, Gallucci GO. Success criteria in implant dentistry: a systematic review. J Dent Res. 2012; 91:242–248.

5. Cosyn J, Eghbali A, De Bruyn H, Dierens M, De Rouck T. Single implant treatment in healing versus healed sites of the anterior maxilla: an aesthetic evaluation. Clin Implant Dent Relat Res. 2012; 14:517–526.

6. Hof M, Pommer B, Strbac GD, Sütö D, Watzek G, Zechner W. Esthetic evaluation of single-tooth implants in the anterior maxilla following autologous bone augmentation. Clin Oral Implants Res. 2013; 24:88–93.

7. Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants. 2004; 19:43–61.

8. Luo Z, Zeng R, Luo Z, Chen Z. Single implants in the esthetic zone: analysis of recent peri-implant soft tissue alterations and patient satisfaction. A photographic study. Int J Oral Maxillofac Implants. 2011; 26:578–586.

9. Baracat LF, Teixeira AM, dos Santos MB, da Cunha Vde P, Marchini L. Patients' expectations before and evaluation after dental implant therapy. Clin Implant Dent Relat Res. 2011; 13:141–145.

10. Cosyn J, Eghbali A, De Bruyn H, Dierens M, De Rouck T. Single implant treatment in healing versus healed sites of the anterior maxilla: an aesthetic evaluation. Clin Implant Dent Relat Res. 2012; 14:517–526.

11. Hartlev J, Kohberg P, Ahlmann S, Andersen NT, Schou S, Isidor F. Patient satisfaction and esthetic outcome after immediate placement and provisionalization of single-tooth implants involving a definitive individual abutment. Clin Oral Implants Res. 2014; 25:1245–1250.

12. Traini T, Pettinicchio M, Murmura G, Varvara G, Di Lullo N, Sinjari B, Caputi S. Esthetic outcome of an immediately placed maxillary anterior single-tooth implant restored with a custom-made zirconia-ceramic abutment and crown: a staged treatment. Quintessence Int. 2011; 42:103–108.

13. Belser U, Buser D, Higginbottom F. Consensus statements and recommended clinical procedures regarding esthetics in implant dentistry. Int J Oral Maxillofac Implants. 2004; 19:73–74.

14. Meijer HJ, Stellingsma K, Meijndert L, Raghoebar GM. A new index for rating aesthetics of implant-supported single crowns and adjacent soft tissues-the Implant Crown Aesthetic Index. Clin Oral Implants Res. 2005; 16:645–649.

15. Fürhauser R, Florescu D, Benesch T, Haas R, Mailath G, Watzek G. Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res. 2005; 16:639–644.

16. Belser UC, Grütter L, Vailati F, Bornstein MM, Weber HP, Buser D. Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: a cross-sectional, retrospective study in 45 patients with a 2- to 4-year follow-up using pink and white esthetic scores. J Periodontol. 2009; 80:140–151.

17. Tettamanti S, Millen C, Gavric J, Buser D, Belser UC, Brägger U, Wittneben JG. Esthetic evaluation of implant crowns and peri-implant soft tissue in the anterior maxilla: Comparison and reproducibility of three different indices. Clin Implant Dent Relat Res. 2016; 18:517–526.

18. Kokich VO Jr, Kiyak HA, Shapiro PA. Comparing the perception of dentists and lay people to altered dental esthetics. J Esthet Dent. 1999; 11:311–324.

19. Gehrke P, Degidi M, Lulay-Saad Z, Dhom G. Reproducibility of the implant crown aesthetic index-rating aesthetics of single-implant crowns and adjacent soft tissues with regard to observer dental specialization. Clin Implant Dent Relat Res. 2009; 11:201–213.

20. Cho HL, Lee JK, Um HS, Chang BS. Esthetic evaluation of maxillary single-tooth implants in the esthetic zone. J Periodontal Implant Sci. 2010; 40:188–193.

21. Andersson B, Bergenblock S, Fürst B, Jemt T. Long-term function of single-implant restorations: a 17- to 19-year follow-up study on implant infraposition related to the shape of the face and patients' satisfaction. Clin Implant Dent Relat Res. 2013; 15:471–480.

22. Buser D, Bornstein MM, Weber HP, Grütter L, Schmid B, Belser UC. Early implant placement with simultaneous guided bone regeneration following single-tooth extraction in the esthetic zone: a cross-sectional, retrospective study in 45 subjects with a 2- to 4-year follow-up. J Periodontol. 2008; 79:1773–1781.

23. Weber HP, Buser D, Fiorellini JP, Williams RC. Radiographic evaluation of crestal bone levels adjacent to nonsubmerged titanium implants. Clin Oral Implants Res. 1992; 3:181–188.

24. Lavigne SE, Krust-Bray KS, Williams KB, Killoy WJ, Theisen F. Effects of subgingival irrigation with chlorhexidine on the periodontal status of patients with HA-coated integral dental implants. Int J Oral Maxillofac Implants. 1994; 9:156–162.

25. Wolfart S, Thormann H, Freitag S, Kern M. Assessment of dental appearance following changes in incisor proportions. Eur J Oral Sci. 2005; 113:159–165.

26. Mombelli A, Lang NP. Clinical parameters for the evaluation of dental implants. Periodontol 2000. 1994; 4:81–86.

27. den Hartog L, Slater JJ, Vissink A, Meijer HJ, Raghoebar GM. Treatment outcome of immediate, early and conventional single-tooth implants in the aesthetic zone: a systematic review to survival, bone level, soft-tissue, aesthetics and patient satisfaction. J Clin Periodontol. 2008; 35:1073–1086.

28. Pjetursson BE, Lang NP. Prosthetic treatment planning on the basis of scientific evidence. J Oral Rehabil. 2008; 35:72–79.

29. Hartog L, Meijer HJ, Santing HJ, Vissink A, Raghoebar GM. Patient satisfaction with single-tooth implant therapy in the esthetic zone. Int J Prosthodont. 2014; 27:226–228.

30. Palmqvist S, Soderfeldt B, Arnbjerg D. Subjective need for implant dentistry in a Swedish population aged 45-69 years. Clin Oral Implants Res. 1991; 2:99–102.

31. Lai HC, Zhang ZY, Wang F, Zhuang LF, Liu X, Pu YP. Evaluation of soft-tissue alteration around implant-supported single-tooth restoration in the anterior maxilla: the pink esthetic score. Clin Oral Implants Res. 2008; 19:560–564.

32. Adell R, Lekholm U, Rockler B, Brånemark PI. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg. 1981; 10:387–416.

33. Jemt T. Regeneration of gingival papillae after single-implant treatment. Int J Periodontics Restorative Dent. 1997; 17:326–333.

34. Chang M, Wennström JL, Odman P, Andersson B. Implant supported single-tooth replacements compared to contralateral natural teeth. Crown and soft tissue dimensions. Clin Oral Implants Res. 1999; 10:185–194.

35. Priest G. Predictability of soft tissue form around single tooth implant restorations. Int J Periodontics Restorative Dent. 2003; 23:19–27.

36. Gehrke P, Lobert M, Dhom G. Reproducibility of the pink esthetic score-rating soft tissue esthetics around single-implant restorations with regard to dental observer specialization. J Esthet Restor Dent. 2008; 20:375–384.