title: 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.
abstract: BACKGROUND
  To validate the concept of early implant placement for use in the esthetically sensitive anterior maxilla, clinical trials should ideally include objective esthetic criteria when assessing outcome parameters.
  
  
  METHODS
  In this cross-sectional, retrospective 2- to 4-year study involving 45 patients treated with maxillary anterior single-tooth implants according to the concept of early implant placement, a novel comprehensive index, comprising pink esthetic score and white esthetic score (PES/WES; the highest possible combined score is 20), was applied for the objective esthetic outcome assessment of anterior single-tooth implants.
  
  
  RESULTS
  All 45 anterior maxillary single-tooth implants fulfilled strict success criteria for dental implants with regard to osseointegration, including the absence of peri-implant radiolucency, implant mobility, suppuration, and pain. The mean total PES/WES was 14.7 +/- 1.18 (range: 11 to 18). The mean total PES of 7.8 +/- 0.88 (range: 6 to 9) documents favorable overall peri-implant soft tissue conditions. The two PES variables facial mucosa curvature (1.9 +/- 0.29) and facial mucosa level (1.8 +/- 0.42) had the highest mean values, whereas the combination variable root convexity/soft tissue color and texture (1.2 +/- 0.53) proved to be the most difficult to fully satisfy. Mean scores were 1.6 +/- 0.5 for the mesial papilla and 1.3 +/- 0.5 for the distal papilla. A mean value of 6.9 +/- 1.47 (range: 4 to 10) was calculated for WES.
  
  
  CONCLUSIONS
  This study demonstrated that anterior maxillary single-tooth replacement, according to the concept of early implant placement, is a successful and predictable treatment modality, in general, and from an esthetic point of view, in particular. The suitability of the PES/WES index for the objective outcome assessment of the esthetic dimension of anterior single-tooth implants was confirmed. However, prospective clinical trials are needed to further validate and refine this index.
authors.affiliation: Department of Fixed Prosthodontics and Occlusion, School of Dental Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Urs C
authors.initials: UC
authors.lastname: Belser
authors.forename: Linda
authors.initials: L
authors.lastname: Grütter
authors.forename: Francesca
authors.initials: F
authors.lastname: Vailati
authors.forename: Michael M
authors.initials: MM
authors.lastname: Bornstein
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Weber
authors.forename: Daniel
authors.initials: D
authors.lastname: Buser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001641:Bicuspid; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003442:Crowns; D003481:Cuspid; D019250:Dental Implants, Single-Tooth; D003764:Dental Materials; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D004955:Esthetics, Dental; D005500:Follow-Up Studies; D005881:Gingiva / Q000033:anatomy & histology*; D006801:Humans; D007180:Incisor; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D010149:Postoperative Pain / Q000145:classification; D017060:Patient Satisfaction; D010510:Periodontal Diseases / Q000145:classification; D012189:Retrospective Studies; D014025:Titanium; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003764:Dental Materials; D014025:Titanium