Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score

Aim: In this study, the reproducibility of a newly developed pink esthetic score (PES) for evaluating soft tissue around single‐tooth implant crowns was assessed. The effect of observer specialization was another point of interest. Material and methods: Twenty observers (five prosthodontists, five oral surgeons, five orthodontists and five dental students) were given photographs of 30 single‐tooth implant crowns. Seven variables were evaluated vs. a natural reference tooth: mesial papilla, distal papilla, soft‐tissue level, soft‐tissue contour, alveolar process deficiency, soft‐tissue color and texture. Using a 0‐1‐2 scoring system, 0 being the lowest, 2 being the highest value, the maximum achievable PES was 14. Each observer was requested to make two assessments at an interval of 4 weeks. At the second assessment, the photographs were scored in the reverse order. Results: The mean PES of evaluations at the first assessment (n=600) was 9.46 (±3.81 SD), and 9.24 (±3.8 SD) at the second one. The difference between these two means was not significant statistically (P=0.6379). Implant‐related mean PES for single‐tooth implants varied from 2.28 to 13.8, with standard deviations between 0.46 and 3.51. Very poor and very esthetic restorations showed the smallest standard deviations. The mean total PES was 10.6 for the prosthodontists, 9.2 for the oral surgeons, 9.9 for the dental students and 7.6 for the orthodontists. Conclusions: The PES reproducibly evaluates peri‐implant soft tissue around single‐tooth implants. Thus, an objective outcome of different surgical or prosthodontic protocols can be assessed. Orthodontists were clearly more critical than the other observers. Résumé Dans cette étude la reproduction d'un nouveau Score d'Esthétique Rose (PES) pour l'évaluation des tissus mous autour des couronnes d'implants uniques a étéévaluée. L'effet de la spécialisation de l'observateur était un autre point d'intérêt. Vingt observateurs (cinq spécialistes en prothèse, cinq chirurgiens, cinq orthodontistes et cinq étudiants en médecine dentaire) ont reçu des photographies de 30 couronnes sur implant unique. Sept variables ont étéévaluées vs une dent de référence naturelle : papille mésiale, papille distale, niveau du tissu mou, couleur du tissu mou, perte du processus alvéolaire, couleur du tissu mou et texture. En utilisant un système 0–1–2, zéro étant le plus bas et deux étant la plus haute valeur, le score maximum PES était donc de 14. Chaque observateur a reçu