den Hartog, L., Raghoebar, G.M., Huddleston Slater, J.J., Stellingsma, K., Vissink, A., Meijer, H.J.A.

Aim: To evaluate the aesthetic outcome of single-tooth implants in the aesthetic zone with different neck designs from a professional’s and patient’s perception.

Materials and methods: Ninety-three patients with a missing anterior tooth in the maxilla were randomly assigned to be treated with an implant with a smooth neck, a rough neck with grooves, or a scalloped rough neck with grooves. Implants were installed in healed sites. One year after definitive crown placement (18 months post implant placement), photographs were taken and the aesthetic outcome was assessed according to two objective aesthetic indexes: pink esthetic score/white esthetic score (PES/WES) and implant crown aesthetic index (ICAI). A questionnaire was used to assess the aesthetic outcome and general satisfaction from a patient’s perception. Standardised radiographs were taken to measure marginal bone level changes.

Results: One implant was lost. Although there was a significant difference in marginal bone loss between the different implant neck designs (smooth neck 1.19±0.82mm, rough neck 0.90±0.57mm, scalloped neck 2.01±0.77mm), there were no differences in aesthetic outcome. According to the professional’s assessments using PES/WES and ICAI, 79.3% and 62% of the cases showed acceptable crown aesthetics, and 59.8% and 56.5% of the cases showed acceptable mucosa aesthetics. Overall, patients were satisfied about the aesthetics of the mucosa (81.5%) and crown (93.3%), and general patient satisfaction was high (9.0±1.0 out of a maximum of 10). According to the professional’s assessment, a pre-implant augmentation procedure was associated with less favourable aesthetics of the mucosa.

Conclusion: This study shows that the aesthetics of single-tooth implants in the maxillary aesthetic zone appears to be independent of the implant neck designs applied but dependent on the need for pre-implant surgery.

Clinical Implant Dentistry and Related Research 2013; 15 (3): 311-470.