ESTHETIC EVALUATION OF IMPLANT RESTORATION IN ESTHETIC ZONE: A LONG-TERM FOLLOW-UP

Abstract

The objective of this research was to investigate the correlation between esthetic outcomes of single-tooth implant restorations (STIRs) over an extended follow-up period, utilizing three evaluation tools: the Pink Esthetic Score (PES), White Esthetic Score (WES), and the novel Esthetic Sustainable Criteria (ESC). A retrospective cross-sectional analysis was conducted on 12 patients who received STIRs at the right central incisor. Comprehensive demographic data, clinical protocols, and follow-up outcomes were meticulously recorded. PES and WES assessed esthetic results focusing on soft tissue and prosthetic appearance, while ESC incorporated additional parameters for evaluating gingival health, prosthesis quality, and bone-implant interface stability. Statistical analyses, including ANOVA and K-means cluster analysis, were employed to identify trends and correlations among the variables. The results revealed that PES/WES scores varied from 12 to 18 (mean: 16.16 ± 1.90), while ESC scores ranged from 24 to 36 (mean: 30.08 ± 3.52). Notably, K-means cluster analysis identified three distinct groups: excellent, medium, and divergent. Over the long-term follow-up, outcomes were generally acceptable to excellent. Patients with higher ESC scores, particularly in bone stability, demonstrated more sustainable esthetic results. In contrast, the divergent group exhibited high PES/WES scores but lower ESC scores, particularly in bone parameters, suggesting a disconnect between soft tissue esthetics and underlying bone conditions. These findings underscore the importance of a multifactorial approach when evaluating long-term esthetic success, emphasizing that sustainable outcomes depend not only on immediate visual esthetics but also on the long-term stability of peri-implant bone and soft tissue architecture.