Treatment Outcome and Patient Satisfaction with Two Adjacent Implant-Supported Restorations in the Esthetic Zone

The purpose of this study was to evaluate the clinical and radiographic parameters as well as the esthetic outcome of two adjacent implant-supported restorations and the surrounding peri-implant mucosa in the maxillary esthetic zone. Ten patients were treated with two adjacent implants in the anterior maxillary zone according to the same protocol. Only patients who had been subjected to a separate previous augmentation procedure with autogenous bone were included in this study. The following parameters were analyzed: implant survival, marginal bone level, vertical distance between the contact point and the bone crest, Papilla Index, probing depth, Aesthetic Index, and patient satisfaction. Implant survival was 100%. The interimplant bone crest level was positioned significantly more apical than the bone crest level between the implant and its neighboring tooth. In addition, complete filling of the interproximal space was observed between two adjacent implant-supported restorations in only 1 of 10 patients, whereas the papilla between the implant and its neighboring natural tooth was present in 70% of patients. Furthermore, patients rated the esthetic outcome of their implant-supported restorations and the surrounding mucosa in all cases as "acceptable," while the clinicians, using the Implant Crown Aesthetic Index, determined six to be "acceptable" and four "unacceptable." Although many patients were satisfied with the esthetic result, it is difficult to establish an acceptable esthetic result with two adjacent implant-supported restorations in the esthetic zone in patients who needed a separate augmentation procedure, according to the contemporary standards of dental professionals.