• Supreda Suphanantachat, D.D.S.
• Ketsuda Thovanich, D.D.S., M.Sc. (Prosthodontics)
• Kanokwan Nisapakultorn, D.D.S., Ph.D., Diplomate, American Board of Periodontology

Objective The purpose of this study was to assess and compare patientsûand cliniciansû judgments of
the esthetic outcome of single-tooth anterior maxillary implants. In addition, the effect of facial
marginal recession on the rating of esthetic outcomes was evaluated.

Materials and methods Thirty patients restored with single-tooth anterior maxillary dental implants
from the Faculty of Dentistry, Chulalongkorn University were recruited for the study. The patients
were asked to rate their satisfaction on four esthetic and four lifestyle-related variables using visual
analog scale (VAS). Six clinicians, including 2 periodontists, 2 orthodontists and 2 prosthodontists,
were given the clinical photograph of these implants and were also asked to rate their satisfaction on
esthetic-related variables. The VAS score of the patient and clinician on the same variables was
compared and the correlation between these scores was determined. Binary logistic regression was
used to analyze the effect of each variable on overall esthetic satisfaction. Furthermore, the effect of
facial marginal recession on the rating of each esthetic-related variable was assessed.

Results For esthetic-related variables, the patients showed high overall esthetic satisfaction (85.9%),
and high satisfaction on crown shape and color. However, their satisfaction on the harmonization of
gingival margin was relatively low (66.6%). For lifestyle-related variables, high satisfaction was
shown for all except for the comfort when chewing or biting (70.1%). The VAS score of the clinicians
was statistically significantly lower than that of patients for all variables (p < 0.05). No correlation
was found between the VAS score given by patients and clinicians for all esthetic-related variables.
The presence of facial marginal recession had no significant effect on the VAS scores assessed by
patients towards all esthetic-related variables, including the harmonization of gingival margin itself.
In contrast, facial marginal recession significantly affected the VAS score rated by clinicians,
especially by periodontists.

Conclusion Patients were highly satisfied with the outcome of their single-tooth anterior maxillary
implants. Clinicians, however, showed lower degree of satisfaction than patients. There was no
correlation between patientsû and cliniciansû judgment towards esthetic outcomes. Facial marginal
recession, which is considered critical for esthetic satisfaction by clinicians, did not appear to be
significant for esthetic satisfaction from the patientsû standpoint.

(CU Dent J. 2010;33:1-14)