Evaluation of the aesthetic outcomes of single implant supported restorations

In recent years, dental implants have become one of the most common treatment options for replacing missing teeth. In cases of single tooth loss where the neighboring teeth are relatively healthy, dental implants are increasingly being preferred over crown bridge restorations. In an ideal aesthetic implant restoration case, the mucosal margin around the implant, and the color, texture, and contour of the peri-implant soft tissue should be compatible with the adjacent and contralateral teeth and/or implants. The aesthetic evaluation of single implant-supported prostheses is crucial for enhancing patient satisfaction, optimizing treatment outcomes, and improving the clinical practices of dentists. This study aims to thoroughly evaluate the aesthetic performance of single implant-supported prostheses performed at Uşak University Faculty of Dentistry due to this aesthetic orientation. Our research is a retrospective, cross-sectional study aiming to examine intraoral photographs of single implant-supported prostheses performed on patients at Uşak University Faculty of Dentistry between January 2019 and March 2024. The prostheses were photographed using a Nikon d7100 body and a Nikon 105mm micro lens (f/2.8G), with a Nikon R1C1 macro twin flash as the light source. The patients' photographs were evaluated by five prosthodontists. The aesthetics of the prostheses were scored using the PES (Pink Esthetic Score) / WES (White Esthetic Score) by comparing them to the contralateral reference teeth. Descriptive and frequency analysis of PES/WES was conducted. The data were analyzed using the IBM SPSS.27 program with appropriate tests. Conclusion: In this study, no significant relationship was found between gender, age, immediate implantation, immediate loading, and WES, PES, or PES/WES scores. However, it was observed that younger patients had notably higher aesthetic scores than older patients, suggesting that aging negatively impacts soft and hard tissues, thereby reducing aesthetic outcomes. Patients with good periodontal health showed significantly higher PES and PES/WES scores, highlighting the importance of periodontal health in achieving aesthetic success. Increased implant depth was associated with a decrease in PES and PES/WES scores, underscoring the importance of accurately adjusting implant depth for optimal aesthetic performance. Additionally, patients with a mesial and distal contact point and bone crest level of 5 mm or less had higher aesthetic scores. According to multiple linear regression analysis, variables including age, implant depth, and mesial-distal contact point with bone level explained 30% of the PES/WES total score.