The overall esthetic assessment of anterior single-tooth implant restoration using esthetic sustainable criteria in 5-year clinical cross-sectional study

Abstract

Objective: To compare the esthetic score (using the Esthetic Sustainable Criteria) among titanium, zirconia and gold alloy abutments of single tooth implant in 5 years follow up. Mateirals and Methods: 24 patients who were treated with single anterior implant at Faculty of Dentistry, Chulalongkorn University were recruited. There were 8 patients for each abutment material. Demographic data, biological parameters such as modified plaque index (mPI), modified sulcus bleeding index (mSBI), probing depth (PD), radiographic images (Periapical films and CBCT images) were collected. The esthetic score (gingival, prosthodontic and bone score) was evaluated according to the Esthetic Sustainable Criteria. The mean difference of modified sulcus bleeding index, gingival score, prosthodontic score and bone score were analysed by Kruskal-Wallis. While the mean differences of labial bone thickness, labial bone height, the distance from implant platform to the first bone-implant contact (DIB), pocket depth were compared by One-Way ANOVA. Furthermore, the comparison of labial bone thickness and height between 0-2 years and 5 years were analyzed by paired t-test, which 0.05 was the significant level. Results: All abutment materials showed similar modified plaque index (mPI), modified sulcus bleeding index (mSBI), mean of probing depth (PD) and esthetic score (gingival, prosthodontic and bone score). Moreover, zirconia abutment illustrated better implant axis score than titanium abutment significantly. Furthermore, labial bone thickness was significantly reduced from 0-2 years to 5 years in titanium and zirconia abutments. And labial bone height was also shown to be significantly decreased in zirconia and gold alloy groups. Conclusion: Within the limitations of this study, these three abutment materials showed the similar acceptable status for periodontal parameters such as modified plaque index, modified sulcus bleeding index, probing depth, esthetic score in term of peri-implant soft tissue and prosthesis during 5 years follow up period. However, the comparison of labial bone thickness and height alterations among abutment materials could not be concluded. Because the number of CBCT images at 0-2 years in each abutment group was not equal. It was suggested that more study with a larger sample size should be conducted.