Esthetic Evaluation Of Natural Teeth By Pink And White Esthetic Scores

Objective:The criteria of a successful implant reconstruction,belong with the advance of dental implant technology and materials,has been changed from the earliest survival rate to the long-term stability,further upgrade to have the optimal aesthetic appearance,especially the aesthetic zone.How to evaluate theaesthetic outcome of the dental implantrestoration gradually be taken seriously.Hence,various aesthetic evaluation indices have been proposed.In the current literature,the Pink Esthetic Score(PES)andthe White Esthetic Score(WES)are frequently used for esthetic evaluations ofsingle implant crowns.Although in the past study,has set the threshold score ofclinical acceptance and(almost)perfect outcome,but did not put forward the reliable theory basis.Based on that to repair the natural appearance of patient is the ideal purpose for any rehabilitation therapy,and furthermore,the Pink and the White esthetic scores are both take the natural teeth as references.The aim of this study is to build up the reference score of the esthetic outcome of the implant support restoration in the esthetic zone through measuring the PES and WES of natural front teeth.Materials and Methods:Collected 102 subjects,the age distribution of 18 to 53 years old,and the average age of 25.66 years old,and in the maxillary anterior teeth aesthetic area without missing teeth,without Root Canal Therapy history,no history of trauma,no rehabilitation therapy history and obvious periodontal disease.Teeth in the esthetic zone photographed by digital single lens reflex camera.Evaluate the incisor,lateral incisor and canine of each subject,totally 306 teeth,by PES and WES.The observers are 12 clinical dentist ofvariable specialization(3 implantodontists,3 prosthodontists,3 orthodontists,3endodontists).All statistical analyses were run onthe SPSS.Results:The PES average score of the 306 teeth from 102 subjects is 12.92(±1.03SD),themedian is 13.25,the 90% reference range is from 10.86 to 13.92.While,the WES average score is 8.75(±0.98SD),the median is 9.00,the 90% reference range is from6.81 to 9.75.The lowest mean score of the seven variables of PES appear inLevel of soft-tissue margin 1.71(±0.25SD)and Soft-tissue contour 1.76(±0.24SD).The lowest mean score of the five variables of WES appear in Outline and Volume 1.56(±0.30SD).The PES mean score of 18-25 years old subjects of this study is 12.98(±1.10SD),and WES is 8.84(±0.95SD).meanwhile,the mean score of 26-53 years old subjects is PES12.82(±0.90SD)and WES 8.61(±1.03SD).The P value of these two group >0.05 of both PES and WES.But the mean scores of Mesial and Distal papilla of 18-25 years old subjects are 1.91(±0.16SD)and 1.94(±0.10SD)compare to 1.75(±0.34)and1.82(±0.27SD)of 26-53 years old subjects,the P value <0.001.The ratings given by different specializations dentists showed the lowest score of PES for prosthodontists12.76(±0.86SD)and orthedontists 12.64(±0.72),and the lowest score of WES for orthodontists 8.61(±0.70)and implantodontist 8.54(±1.00).Conclusions:According to the experimental data in limited within the scope of the study,suggest that the score of PES attend 11,and WES attend 7,can be regarded up to the level of natural teeth.In addition PES total score of 13 and WES of 9,these score better than50% natural teeth,can be considered(almost)perfect.Level of soft-tissue margin,Soft-tissue contour and Outline/Volume of the crown are high risk parameters in esthetic outcomes of implant reconstructions,because the worse situation in natural teeth than other parameters.The scores of PES and WES have the downward trend while the age increasing,although the data have no statistical significant.The mesial and Distal papilla are the most age-relate sensitive variables.Synthesis of PES and WES orthodontists scoring the most strictly.