Comparative clinical evaluation of esthetic parameters of immediately provisionalized implants in the esthetic zone with their natural counterparts

Background: An anterior single implant-supported crown restoration in the maxillary anterior region must meet a particularly high standard of esthetic quality. The standard of care for edentulous space in esthetic zone therefore would be the placement of an implant with immediate provisionalization. Aims and Objecectives: The aim of this study is to evaluate the esthetic parameters of immediately provisionalized implants in the esthetic zone and compare patients opinion with blinded clinicians opinion of the outcome of esthetics of implant in esthtic zone. Materials and Methods: In our study, we placed 10 maxillary anterior single-tooth implants in fully healed maxillary anterior sites in esthetic zone. All the implants were provisionalized within 24 hours. Zirconia prosthesis was delivered as definitive prosthesis after three months of implant placement. The esthetic zone was photographed three months after delivering the definitive prosthesis. The esthetic outcome was then evaluated objectively using Pink Esthetic Score (PES) and White Esthetic Score (WES) by a blinded clinician. In addition, we used a triple score technique Visual Analogue Scale(VAS) wherein the patients commented on the soft tissue, prosthetic as well as the overall esthetic outcome. Results: A mean PES of 9.2± 1.03 and a mean WES of 8.7± 1.16 recorded showed an acceptable peri-implant soft tissue outcome and an acceptable prosthetic outcome respectively. The statistical analysis revealed statistically significant correlation between patients' esthetic perception and dentists' perception of the anterior tooth. Conclusion: The PES/WES is an objective tool in rating the esthetics of implant supported single crowns and adjacent soft tissues. Orthodontists were the most critical observers, while periodontists were more generous than other observers. The statistical analysis revealed a statistically significant correlation between patients' esthetic perception and dentists' perception of the anterior tooth.