title: Single implant-supported crowns in the aesthetic zone: patient satisfaction with aesthetic appearance compared with appraisals by laypeople and dentists.
abstract: OBJECTIVE
  To appraise the patients' satisfaction with aesthetic outcomes following an implant restoration in the anterior maxilla as compared to appraisals made by dentists and laypeople.
  
  
  METHODS
  Randomly selected patients (n = 116) restored with an implant-retained crown in the anterior maxilla were invited to rate their satisfaction with aesthetic outcomes using a questionnaire containing seven criteria, each graded from excellent to poor. Projected images of the patient smiles were appraised by dentists (n = 8) and laypeople (n = 6) using the same assessment criteria in a room setting. In addition, the laypeople judged the same cases on printed 10 × 15 cm photographs in a separate setting. Jemt papilla scores, pink aesthetic score (PES) and white esthetic score (WES) were assigned by the dentists. Differences in the levels of satisfaction between the patient, and appraisals by the dentists and the laypeople were compared using non-parametric statistical tests.
  
  
  RESULTS
  Patients' opinions of their aesthetic appearance following the placement of a single implant-supported crown in the aesthetic zone were in general very favourable. The laypeople were more critical than the dentists when the aesthetic outcomes were appraised on magnified images projected onto a screen. Laypeople became less critical when evaluating the aesthetic outcomes on printed photographs compared to appraisals on a screen. Patient satisfaction with their aesthetic appearance differed from dentists' and laypeople's appraisals.
  
  
  CONCLUSIONS
  Factors other than the actual aesthetic outcome itself appear to influence patients' satisfaction with their end results. Laypeople's appraisal is influenced by the magnification and method used for appraising the aesthetic outcomes.
authors.affiliation: Department of Prosthodontics, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.|Private Practice, Toronto, ON, Canada.
authors.forename: Joseph
authors.initials: J
authors.lastname: Fava
authors.affiliation: Department of Prosthodontics, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.|Private Practice, Toronto, ON, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Lin
authors.affiliation: Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Zahran
authors.affiliation: Department of Prosthodontics, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.|UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Asbjorn
authors.initials: A
authors.lastname: Jokstad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003442:Crowns; D015921:Dental Implants; D003815:Dentists / Q000523:psychology*; D004955:Esthetics, Dental; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D011897:Random Allocation; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D015921:Dental Implants
keywords: dental implant; implant aesthetics; patient centered outcomes; prosthodontics; soft tissue-implant interactions