Esthetic Evaluation Using the Pink Esthetic Score after Immediate Post-Extraction Single Implant Placement and Provisionalization in the Anterior Maxillae.

H. Antoun, M. Karouni, Paris, FrancePurpose

This case series evaluated peri-implant soft tissue of immediately placed and provisionalized

maxillary anterior single implants. The Pink esthetic score has been used to rate the esthetic

outcome of the treated cases.

Methods:

Fifteen patients each received a single implant in the esthetic zone were consecutively followed.

The treatment consisted of tooth extraction, implant placement, anorganic bone graft and

connective tissue graft. Soft tissues were evaluated by 7 observers before the surgery (v1) and at

least 1 year after final prosthesis placement (v2). They were shown photographs of 15 single-tooth

implant crowns and variables were evaluated vs. a natural reference tooth: mesial papilla, distal

papilla, soft-tissue level, soft-tissue contour, alveolar process deficiency, soft-tissue color and

texture.

Results:

Of the inserted implants 100% survived and of the definitive crowns mounted a survival of 100% was

observed. Data were analyzed with “Student’s t-test” and we noticed that the mean total PES score is

5.73 (±1.45 SD) and 7.35 (±0.97SD) on v1 and v2 respectively and varied from 3 to 8.42 on v1 and

from 6 to 9.2 on v2. Statistical analysis revealed significant difference between presurgery and at the

follow up examination of the anterior single implant (P=0.0003). The scores of the variables increased

significantly at a mean follow-up of 4.26 years (range:1 to 8)

Conclusion:

Within the limitations of this study, the esthetic outcome of soft tissues around anterior tooth implant

after atraumatic tooth extraction associated to a hydroxyapatite bone graft and connective tissue

graft seems to be maintained or improved significantly compared with baseline and according to PES

assessment. A prospective study with more patients and a longer mean follow up is needed.

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References:

Massimo Del Fabbro, Valentina Ceresoli, Silvio Taschieri, Caterina Ceci, Tiziano Testori. Immediate Loading of Postextraction Implants in the Esthetic Area: Systematic Review of the Literature. Clin Implant Dent Relat Res. 2013 Apr 22

Belser UC, Grütter L, Vailati F, Bornstein MM, Weber HP, Buser D. Outcome Evaluation of Early Placed Maxillary Anterior Single-Tooth Implants Using Objective Esthetic Criteria: A Cross-Sectional, Retrospective Study in 45 Patients With a 2- to 4-Year Follow-Up Using Pink and White Esthetic Scores. J Periodontol. 2009 Jan;80(1):140-51.

Figures 1 to 3: Vestibular views at baseline, surgery and final prosthesis placement

Chart 1: Distribution of the sites

Chart 2: Bar diagram to illustrate mean values of the 5 criteria of the PES

v1 v2