title: Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score.
abstract: OBJECTIVE
  In this study, the reproducibility of a newly developed pink esthetic score (PES) for evaluating soft tissue around single-tooth implant crowns was assessed. The effect of observer specialization was another point of interest.
  
  
  METHODS
  Twenty observers (five prosthodontists, five oral surgeons, five orthodontists and five dental students) were given photographs of 30 single-tooth implant crowns. Seven variables were evaluated vs. a natural reference tooth: mesial papilla, distal papilla, soft-tissue level, soft-tissue contour, alveolar process deficiency, soft-tissue color and texture. Using a 0-1-2 scoring system, 0 being the lowest, 2 being the highest value, the maximum achievable PES was 14. Each observer was requested to make two assessments at an interval of 4 weeks. At the second assessment, the photographs were scored in the reverse order.
  
  
  RESULTS
  The mean PES of evaluations at the first assessment (n=600) was 9.46 (+/-3.81 SD), and 9.24 (+/-3.8 SD) at the second one. The difference between these two means was not significant statistically (P=0.6379). Implant-related mean PES for single-tooth implants varied from 2.28 to 13.8, with standard deviations between 0.46 and 3.51. Very poor and very esthetic restorations showed the smallest standard deviations. The mean total PES was 10.6 for the prosthodontists, 9.2 for the oral surgeons, 9.9 for the dental students and 7.6 for the orthodontists.
  
  
  CONCLUSIONS
  The PES reproducibly evaluates peri-implant soft tissue around single-tooth implants. Thus, an objective outcome of different surgical or prosthodontic protocols can be assessed. Orthodontists were clearly more critical than the other observers.
authors.affiliation: Department of Prosthodontics, Dental School, Medical University of Vienna, Vienna, Austria. rudolf@fuerhauser.at
authors.forename: Rudolf
authors.initials: R
authors.lastname: Fürhauser
authors.forename: Dionisie
authors.initials: D
authors.lastname: Florescu
authors.forename: Thomas
authors.initials: T
authors.lastname: Benesch
authors.forename: Robert
authors.initials: R
authors.lastname: Haas
authors.forename: Georg
authors.initials: G
authors.lastname: Mailath
authors.forename: Georg
authors.initials: G
authors.lastname: Watzek
mesh_terms: D000328:Adult; D003116:Color; D003442:Crowns; D003753:Dental Health Surveys; D003758:Dental Implantation, Endosseous / Q000592:standards*; D019250:Dental Implants, Single-Tooth / Q000592:standards*; D019094:Dental Prosthesis, Implant-Supported / Q000592:standards*; D004955:Esthetics, Dental; D005260:Female; D005881:Gingiva / Q000033:anatomy & histology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D023861:Photography, Dental; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric