Relationship between aesthetic subjective and objective evaluation in anterior dental implants

Recent technological developments have increased the popularity of dental implants. This has led to higher expectations for implants in both the functional and aesthetic areas. Aesthetic evaluations tend to be subjective, causing problems when trying to predict patients' satisfaction. The Pink Esthetic Score/White Esthetic Score (PES/WES) is an index used to objectively evaluate anterior implant restorations while the Orofacial Aesthetic Scale (OAS) is a questionnaire used to evaluate the patients' perceptions of their orofacial appearance. The current study assesses the relationship between the objective (using PES/WES) and subjective evaluation (using OAS) of an aesthetic implant restoration. Fifty-six intraoral photographs of anterior implant restorations (N=56) were taken and evaluated using PES/WES. Subjects were then instructed to fill out the OAS questionnaire. The mean total of PES/WES is 13.6±1.67 (range:11 to 15). The mean total of PES is 7±0.70 (range:6 to 8). The two PES parameters of the distal papilla and root convexity (1.6±0.54) have the highest mean values, whereas the variable level of facial mucosa (1±0.01) is the most difficult to satisfy. The mean total of WES is 6.6±1.14 (range 5-8). From the results, a high PES/WES score does not correspond to a high OAS score.