Predictability of implant-supported restorations in the esthetic zone

Abstract

Background. The goal of modern dentistry is to create the most aesthetical dental restoration for the patient. It is essential to use tools and techniques that allow to make a predictable dental implant-based restoration. The specialty literature proposes a variety of indices that help doctors to evaluate the complexity of clinical case and predictability of future restorations. Some of them are: Peri-Implant and Crown Index [PICI], Implant Crown Aesthetic Index [ICAI], Pink Esthetic Score/White Esthetic Score [PES/WES], Pink Esthetic Score [PES], and SAC ITI Tool (Straightforward, Advanced, Complex). Case report. Six patients (aged between 27 and 43 years old) have been included in the research. All cases were 1 and 2 implant restorations in the esthetic area of the upper jaw. From 6 cases 3 were with missing central incisors 2 with lateral incisors and 1 canine. The SAC classification was applied in order to assess the predictability of treatment which included 12 parameters required for assessment prior to implant placement. Each parameter was scored from 1 to 3, the closer to value 3, the higher is the esthetic risk and lower the success rate. The other score applied after provisional crown insertion was the Furhauser pink esthetic score (PES) which includes 7 parameters for evaluation of treatment results in time. The score was periodically assessed at 6 and 12 months after placement of prosthetic restorations. Conclusions. The use of assessment tool prior to surgery provides a vision of mostly common causes of esthetic failures in single tooth restorations in the esthetic area of maxilla. The esthetic risk parameters help the doctors to understand the risk and possible ways of its diminishing even before of implant placement. The PES/WES scores provide an insight into the predictability of prosthetic restoration which is a key factor of treatment planning in order to obtain both surgical and prosthetic approaches for optimal results.