Abstract Peri‐implantitis can be explained using a multicausality model. Many factors are involved in the etiology of peri‐implantitis, but patient compliance also plays a key role. Oral hygiene, attending recall visits, smoking behavior, and therapy comprehension are relevant factors that contribute to peri‐implant health. The clinician should create the most optimal conditions for patients to facilitate adequate oral self‐care and to help patients improve their oral hygiene skills. Implementation of a supportive periodontal therapy program is mandatory to control inflammation and plaque accumulation, as well as to keep the incidence of peri‐implant diseases low. Patient compliance, including plaque control and dental follow‐up, must be optimal. Consequently, precautions must be taken with patients treated with dental implants.
Abstract Background Peri‐implant soft tissues esthetics varies and depends on the restoration type such as implant‐supported single crowns, adjacent multiple single crowns, and fixed partial dentures (FPD). Purpose The aim of this prospective study was to assess the esthetic outcome of the peri‐implant soft tissues of (NobelBiocare™) implant‐supported single crowns, adjacent multiple single crowns, and FPD. A potential association between the esthetic risk profile and the esthetic outcome was assessed. Materials and methods Between 03/11 and 03/17, 300 NobelActive implants were installed in 153 partially edentulous patients. Prior to the fabrication of the final restoration, the esthetic risk profile (ERP) of the patient was determined. The pink esthetic score (PES) and white esthetic score (WES) were assessed by three investigators at 6 and 12 months post‐insertion of the final restoration. Patients' appreciation was assessed on a visual analogue scale (VAS) at the 1‐year follow‐up. Results The clinical acceptable limit for PES (≥6) was achieved in 56% to 68% of the single crowns at 6 and 12 months, respectively. Clinically unacceptable PES scores were recorded for 48% of the adjacent multiple single crowns and 63% of the FPDs at both time points. The association of a high ERP with WES and PESWES was noticed for single implant‐supported crowns. For the latter restoration type, a ≤5 mm distance between the crestal bone level and the proximal contact positively influenced the PES and combined PESWES scores. No correlation was found between PES or WES and patient satisfaction. Mesial papilla formation was more pronounced compared to the distal one for the single implant crowns and for implant‐supported FPD. Conclusion When high esthetic demands are expected, assessment of ERP prior to implant treatment is advised in order to estimate a realistic outcome.
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