title: Esthetic evaluation of single-tooth implants in the anterior mandible.
abstract: OBJECTIVE
  Single-tooth replacement of anterior mandibular teeth is frequently complicated by insufficient bucco-lingual bone width and limited mesio-distal space available for implant placement. The aim of the present study was to assess implant esthetics in the partially edentulous anterior mandible.
  
  
  METHODS
  Esthetic evaluation of 43 anterior mandibular single-tooth implants in 15 women and 28 men was performed using esthetic indices (PES = Pink Esthetic Score, PI = Papilla Index, SES = Subjective Esthetic Score) as well as subjective patients' Visual Analogue Scale (VAS) ratings. Clinical and radiological parameters (implant and crown dimensions, pocket depth, bleeding on probing, plaque, keratinized mucosa, marginal bone level, and distance to adjacent teeth) were tested for influence.
  
  
  RESULTS
  Implant esthetics were judged satisfactory (PES ≤10) in 42% of implants compared with a patient satisfaction rate of 87%. Correlation between objective indices (PES/PI: rs  = 0.62, PES/SES: rs  = -0.73, PI/SES: rs  = -0.48) was highly significant (P ≤ 0.001); however, no association to subjective patients' ratings could be observed. Type of prosthetic restoration (single crown vs. tulip-shaped double crowns), mesio-distal crown width as well as anatomic crown length significantly affected esthetic scores. Patients' judgment, by contrast, could not be associated to any prognostic factor.
  
  
  CONCLUSIONS
  Subjective patient satisfaction with implant esthetics in the partially edentulous anterior mandible is high, however, remains hard to predict or objectively quantify.
authors.affiliation: Department of Oral Surgery, Bernhard Gottlieb School of Dentistry, Vienna Medical University, Vienna, Austria.
authors.forename: Markus
authors.initials: M
authors.lastname: Hof
authors.forename: Gabor
authors.initials: G
authors.lastname: Tepper
authors.forename: Barbara
authors.initials: B
authors.lastname: Koller
authors.forename: Martin
authors.initials: M
authors.lastname: Krainhöfner
authors.forename: Georg
authors.initials: G
authors.lastname: Watzek
authors.forename: Bernhard
authors.initials: B
authors.lastname: Pommer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D004955:Esthetics, Dental; D005260:Female; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000601:surgery; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D016896:Treatment Outcome
keywords: anterior mandible; dental implants; implant esthetics; mucosal recession; prosthetic restoration; single crown; single-tooth replacement