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Oct 3, 2018


A retrospective study on the aesthetic outcomes of anterior implant-supported single crowns







Systematic reviews report a lack of studies investigating aesthetic outcomes and patient satisfaction for single implant-supported crowns. There is currently no consensus on the use of aesthetic indices for assessing implant aesthetics, making it difficult to compare between studies. Evaluator specialization has also been shown to impact aesthetic determination. The relationship between patient and clinician evaluation of implant aesthetics still requires further investigation. The aim of this study was to compare the aesthetic outcomes of anterior implant-supported single crowns as evaluated by patients and clinicians of different specialties. One hundred and thirty-three patients restored with 138 implant-supported anterior crowns were recalled to rate their satisfaction with the aesthetic outcomes of their restorations using a visual analogue scale (VAS) questionnaire. Three prosthodontically-trained clinicians (PTCs) rated each implant restoration using the modified Pink Esthetic Score/White Esthetic Score (PES/WES) index, with the aid of photographs and models. Two periodontists, two orthodontists, and two general dentists rated a randomized sample of forty implant-supported anterior crowns with PES/WES as well. Statistical analysis was done with the ANOVA, intraclass correlation coefficient (ICC), Kappa, Spearman’s Rank correlation, and Mann-Whitney U tests. Mean PES, WES, and PES/WES scores were 4.7, 5.0, and 9.7, respectively. Only 22 (15.9%) of the 138 implants were deemed clinically acceptable (PES/WES ≥ 12). Mean patient satisfaction scores for each VAS question ranged from 79.3 – 84.4. 84.8% of implants had a mean VAS score of ≥ 70 out of 100. No significant difference was found between VAS scores of implants rated with PES/WES ≥ 12 or < 12, despite a trend towards higher VAS scores for those rated clinically acceptable. VAS scores were not correlated to age, sex, race, implant location, or smile line. There was only weak correlation between PES/WES and patient VAS scores. Patients’ perceptions of crown size showed the best correlation with WES scores (r = 0.27, p < 0.05). PTCs had significantly lower mean scores (p < 0.05) for PES, WES, and PES/WES (4.8, 5.3, 10.0) than the other specialties, which had similar scores. ICCs for PES, WES, and PES/WES were highest for PTCs (r = 0.74, 0.76, 0.86), followed by periodontists (r = 0.69, 0.70, 0.73), and lowest for orthodontists (r = 0.41, 0.60, 0.50). In conclusion, the study found that 84.8% of implants were rated a mean VAS score of ≥ 70 out of 100. Patients were generally less critical of aesthetic outcomes than clinicians. Modified PES/WES index scores varied widely across different specialties and within the same specialty. PTCs were the strictest in assessment of aesthetic outcomes using the modified PES/WES index.

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© Copyright 2019 Morressier GmbH. All rights reserved.

© Copyright 2019 Morressier GmbH.
All rights reserved.