title: A retrospective evaluation of aesthetic outcomes for single-tooth implants in the anterior maxilla.
abstract: OBJECTIVE
  To investigate objective and patient-centred aesthetic outcomes for single-tooth implants in the anterior maxilla.
  
  
  METHODS
  Ninety-eight patients (21 men and 77 women) with a mean age of 51.2 ± 3.8 years were included in this retrospective study. A total of 98 maxillary anterior single-tooth implant crowns with a mean functional time of 68.1 months (range 12-245) were evaluated. Aesthetic outcomes were measured by PES and WES. Statistical analysis was performed using the Mood's median and stepwise logistic regression with backward elimination to assess the effect of patient demographics, clinical parameters and surgical methods on aesthetic outcome (P < 0.05).
  
  
  RESULTS
  The median PES was 11 and 94% of implants were deemed aesthetically acceptable. The median WES was 9 and 98% of implants were deemed aesthetically acceptable. The PES was positively influenced by the use of a connective tissue graft (CTG), adding 1 to the score (P = 0.002) and negatively influenced by membrane use (P = 0.026). Flapless techniques employed as part of an immediate implant placement protocol yielded better outcomes compared to flapped sites (P = 0.017). Immediate implant placement demonstrated greater variability in outcomes compared to early implant placement.
  
  
  CONCLUSIONS
  Satisfactory objective and patient-reported aesthetic outcomes were achieved with dental implants replacing missing single teeth in the anterior maxilla. The use of CTG improved the aesthetic outcome mainly by increasing the alveolar process contour. Less variation in outcomes was observed with early (type 2) placement compared to immediate (type 1 placement).
authors.affiliation: Periodontics, Melbourne Dental School, University of Melbourne, Parkville, Vic., Australia.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Boardman
authors.affiliation: Periodontics, Melbourne Dental School, University of Melbourne, Parkville, Vic., Australia.
authors.forename: Ivan
authors.identifier: http://orcid.org/0000-0002-6457-5327
authors.initials: I
authors.lastname: Darby
authors.affiliation: Periodontics, Melbourne Dental School, University of Melbourne, Parkville, Vic., Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Chen
mesh_terms: D019250:Dental Implants, Single-Tooth; D004955:Esthetics, Dental; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: connective tissue graft; dental aesthetics; dental implants; dental papilla; dentogingival complex; peri-implant; pink esthetic score; white esthetic score