Usefulness of the aesthetic result as a success criterion for implant therapy: a review.
OBJECTIVE
The purpose of this study was to review the reported evaluation criteria of the aesthetic result in oral implant rehabilitation.


METHODS
A literature search of MEDLINE, the Cochrane Collaboration, and EMBASE was performed to retrieve studies published between January 1990 and December 2008 using the following key words: "dental implants,""clinical trial," and "aesthetic index" (and their synonyms). A manual search of the literature published in the same period was also carried out using the following publications: Clinical Oral Implant Research, The International Journal of Oral and Maxillofacial Implants, and The International Journal of Periodontics and Restorative Dentistry. The inclusion criteria of the published studies were the following: human clinical trial, oral implant rehabilitation, at least 10 implants, at least 6 months of follow-up from insertion of the prosthesis, and evaluation of the aesthetic result by means of an index.


RESULTS
The literature search revealed 650 relevant bibliographic references, of which 89 were selected for further analysis. A final total of 29 articles fulfilled the inclusion criteria; these included 10 retrospective case series, 11 prospective case series, 1 retrospective controlled clinical trial, 1 prospective controlled clinical trial, and 6 randomized controlled clinical trials. In general, evaluations of aesthetic results appear only in the more recent studies and refer mostly to implant rehabilitation in the maxillary anterior zone; the index used, in most cases, was the Papilla Index of Jemt.


CONCLUSIONS
Although there appears to be a growing interest in aesthetics in dental implantology, there are as yet no universally accepted evaluation criteria of the aesthetic result. Therefore, further research is necessary to establish a common, complete, and reproducible index for the evaluation of aesthetic outcome that can add in the success criteria for implant therapy in the maxillary and mandibular anterior areas.
Annibali
Susanna
S
Department of Oral Surgery, School of Dentistry, Sapienza University of Rome, Rome, Italy. susanna.annibali@uniroma1.it
Bignozzi
Isabella
I
La Monaca
Gerardo
G
Cristalli
Maria Paola
MP
D003758:Dental Implantation, Endosseous / Q000592:standards*; D015921:Dental Implants / Q000592:standards*; D019094:Dental Prosthesis, Implant-Supported / Q000592:standards*; D004955:Esthetics, Dental; D005069:Evaluation Studies as Topic; D006801:Humans; D017063:Outcome Assessment, Health Care; D010515:Periodontal Prosthesis / Q000592:standards; D015203:Reproducibility of Results
D015921:Dental Implants