Objectives: The important item of aesthetics is rarely included in evaluation studies. The aim of this study was to develop and validate an index for rating aesthetics of implant‐supported single crowns and adjacent soft tissues. Material and methods: Nine items were selected, which have an influence on the aesthetic result. The items are based on the anatomic form, colour and surface characteristics of the crown and on the anatomic form, colour and surface characteristics of the peri‐implant soft tissues. Two oral‐maxillofacial surgeons and two prosthodontists rated 24 implant‐supported single‐tooth restorations and adjacent soft tissues on a form with the nine items of the rating index. The rating was carried out twice by each of the examiners. Weighted Cohen's κ was calculated to express the intra‐ and interobserver agreement. Results: Intraobserver results indicated that the agreement between the first and second rating of both the prosthodontists was good (both 0.7) and that the agreement of the oral‐maxillofacial surgeons was moderate (0.49 and 0.56). The best interobserver agreement was found between the two prosthodontists (0.61, good agreement). Conclusions: The Implant Crown Aesthetic Index is an objective tool in rating aesthetics of implant‐supported single crowns and adjacent soft tissues. The rating is best be carried out by one prosthodontist to have the highest reliability.

The peri-implant mucosa is rated as less satisfactory than the implant-supported crown by both the dental professional and patients. The dental professional was less satisfied with respect to the total result and results of the crown than the patients.

This study shows that the aesthetics of single-tooth implants in the maxillary aesthetic zone appears to be independent of the implant neck designs applied but dependent on the need for pre-implant surgery.

den Hartog L, Raghoebar GM, Stellingsma K, Vissink A, Meijer HJA. Immediate non‐occlusal loading of single implants in the aesthetic zone: a randomized clinical trial. J Clin Periodontol 2011; 38: 186–194. doi: 10.1111/j.1600‐051X.2010.01650.x. Abstract Aim: This study compared the outcome of immediate non‐occlusal loading with conventional loading for single implants in the maxillary aesthetic zone. It was hypothesized that immediate non‐occlusal loading is not inferior to conventional loading. Materials and Methods: Sixty‐two patients with a missing maxillary anterior tooth were randomly assigned to be treated with an implant that was either restored with a non‐occluding temporary crown within 24 h after implant placement (the “immediate group”) or was restored according to a two‐stage procedure after 3 months (the “conventional group”). All implants were installed in healed sites. Follow‐up visits were conducted after 6 and 18 months post‐implant placement. Outcome measures were radiographic marginal bone‐level changes, survival, soft tissue aspects (probing depth, plaque, bleeding, soft tissue level), aesthetics and patient satisfaction. Results: No significant differences were found between both study groups regarding marginal bone loss (immediate group 0.91 ± 0.61 mm, conventional group 0.90 ± 0.57 mm), survival (immediate group 96.8%: one implant lost, conventional group 100%), soft tissue aspects, aesthetic outcome and patient satisfaction. Conclusion: Within the limitations of this study (sample size, follow‐up duration), it was demonstrated that, for single implants in the anterior maxilla, the outcome of immediate non‐occlusal loading was not less favourable than conventional loading.