Esthetic Evaluation of Anterior Single-Tooth Implants with Different Abutment Designs - Patients' Satisfaction Compared to Dentists' Observations

Purpose: To correlate patients' satisfaction and dentists' observations regarding two abutment designs used for single crowns in the esthetic zone: a divergent one (control) and a curved one (experimental), with special emphasis on muco-gingival esthetics. Materials and Methods: Twenty-six patients with nonadjacent missing teeth in the esthetic zone were enrolled in a randomized clinical trial (within-subject comparison). Two implants placed in each were restored using abutments of different geometry. Patients' appreciation was assessed on a visual analog scale (VAS) by recording answers to three questions, and dentists' appreciation was determined by means of the Pink Esthetic Score (PES) at T0 (crown cementation, baseline) and at T12 (1 year post-cementation). ANOVA with post hoc analysis was used to identify differences between groups and at different moments in time. Pearson correlations were calculated between all variables, both at T0 and at T12. Results: No statistically significant differences were found at any time between the control and experimental abutment design, either for the PES or for the VAS score. PES slightly improved after 1 year, as did the VAS rating related to functioning with the implant-crown compared to the natural teeth. All PES and VAS scores demonstrated highly significant correlation. Both patient satisfaction and professional appreciation of muco-gingival conditions after single implant treatment in the esthetic zone were high; however, the curved, experimental abutment design performed no better than the conventional, divergent type. Conclusion: Curved abutment design does not significantly impact crown or gingival esthetics as assessed by PES and VAS scored by dentists and patients, respectively