Longitudinal clinical, esthetic, and patient-centered evaluation of implant-supported single crowns in the esthetic area
Keywords:
Dental implants; Implant-supported prosthesis; Prosthetic abutments; Peri-implant esthetics; Oral health-related quality of life.
This study aimed to longitudinally evaluate the clinical, peri-implant, esthetic, and patient-centered outcomes of implant-supported single crowns in the esthetic region of the maxilla, comparing one-piece prefabricated titanium abutments (UP) with two-piece customized titanium/zirconia abutments (DP). A prospective, non-randomized clinical study was conducted with 24 patients and 25 implants, of which 13 were restored with UP abutments and 12 with DP abutments. Clinical and peri-implant parameters, patient satisfaction using a visual analog scale, and esthetic outcomes assessed with the Pink Esthetic Score (PES) and White Esthetic Score (WES) were evaluated. Associations between clinical and peri-implant characteristics and satisfaction and esthetic outcomes were also investigated. Patient satisfaction increased significantly after rehabilitation in both groups, with no difference between treatments in the magnitude of change. None of the clinical or peri-implant characteristics evaluated was significantly associated with the improvement in satisfaction. Overall, peri-implant parameters remained stable throughout follow-up, although a greater reduction in the visible plaque index was observed in the DP group. PES values were similar between groups at baseline and after definitive crown placement, as was the magnitude of change over time. In contrast, WES was significantly higher in the DP group, indicating a better esthetic outcome of the restoration in this group. Among the peri-implant parameters, only the width of keratinized mucosa showed a significant correlation with PES, whereas no significant associations were observed with WES. These findings indicate that both abutment types showed similar outcomes regarding patient satisfaction, most peri-implant parameters, and soft-tissue esthetics. The main difference was related to restoration esthetics, with customized abutments showing better WES outcomes, whereas peri-implant soft-tissue esthetics were more closely related to the width of keratinized mucosa than to the type of abutment used.