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Aesthetics of implant-supported single anterior maxillary crowns evaluated by objective indices and participants' perceptions.

AIM
The objective of this study was to evaluate the aesthetics of implant-supported single crowns in the anterior maxilla using objective indices and patients' perception.


METHODS
Fifty participants, former patients (mean age 31.3 years) at the Dental Hospital, University of Bergen, or at Haukeland University Hospital in Bergen, Norway, who had implant-supported single crowns replacing upper anterior teeth lost due to trauma or agenesis during 2006, were included. One year after placement of the crown, an evaluation was carried out using the Pink Aesthetic Score (PES), the Implant Crown Aesthetics Index (ICAI), a modified version of the ICAI (mod-ICAI), and the index of the Californian Dental Association (CDA). The participants rated their satisfaction with the crowns and adjacent soft tissue.


RESULTS
The form of the crown was satisfactory for 88% and the colour for 84% of participants, while 72% were satisfied with the adjacent mucosa. A statistically significant bivariate correlation was found between the PES and the ICAI and mod-ICAI. A weaker association was found between the CDA and the ICAI, mod-ICAI and PES. A positive correlation was found between the mod-ICAI index and satisfaction with the form and colour of the crowns and with the sum of ratings of responses to the questions about the form and colour of the crowns and the form and colour of the adjacent mucosa (P<0.05). Although most participants were satisfied, objective evaluation showed that a good aesthetic outcome for single implants was related to the quantity of the peri-implant mucosa.


CONCLUSION
The mod-ICAI index correlated with responses to questions about the form and colour of the mucosa. Other significant correlations were found between the participants' aesthetic perceptions and the ICAI and the mod-ICAI. The mod-ICAI combined best objective and subjective assessment of aesthetics related to implant-supported crowns.