Esthetic Risk Assessment Of Dental Implant In Anterior Area Of Maxilla And Case Reports

Purpose: Cases of dental implant placement in maxillary anterior area using different surgical approaches are collected to analyse with Esthetic Risk Assessment, and the SAC classification combining the surgical and restorative modified factors. PES and WES was applied to evaluate the final restoration, the patients gave their opinion on the aesthetic treatment outcome and satisfactory degree via VAS. And assess whether the final outcomes have met the patients’ expectation or not.Method and material: Via collecting 9 patients with the complain of edentulous in maxillary anterior area who referred to the Affiliated Stomatological Hospital of Fujian Medical University from July 2014 to March 2016. Different surgical methods had been taken, including 6 single-tooth missing and 3 multiple-teeth defects, the age ranges from19 to 64 years old, 4 males and 5 females included. Using ERA to assess the esthetic risk of these cases, which contains these aspects: 1..medical status; 2.smoking habit;3.patient esthetic expectations; 4.lip line; 5.gingival biotype in edentulous area; 6.the shape of the tooth and adjacent teeth; 7.infection at implant site; 8.bone level at adjacent teeth; 9.restoration status of neighboring teeth; 10.width of edentulous span;11.the width and height of the remaining bone and soft tissue. Combing with the surgical and restorative modified factors, we anticipate the difficulty of these cases via SAC classification. Finally, we judge the esthetic perception and score the single-tooth restoration with PES and WES. The assessment team consist of 12 persons from 4departments namely prosthodontic, endodontic, orthodontic and implantology. The final score is the average of the results. Additionally, the patients were asked to give their opinion on the aesthetic treatment outcome and satisfactory degree via VAS.Result: The surgical approaches and bone augmentation methods are different in these9 cases, depending on the different circumstance of patients as the reason of toothmissing, the bone and soft tissue level. 7 cases had already been finally restored in these9 cases, among which there are 4 cases of high esthetic risk, 3 of medium and 2 of low risk. Recalling period is from 1month to 12 months. The PES of all the single-tooth restorations showed an acceptable result. One of the single implant treatment outcome was unfavorable in WES, others are all above the clinical acceptance threshold. The VAS of the patients shows their satisfactions with the outcomes.Conclusion: With the help of ERA and SAC classification, it is beneficial for us to make the therapy plan, to anticipate the esthetic treatment outcomes and to communicate with patients to addressing their expectations appropriately. The PES and WES score of the outcomes are acceptable and patients’ satisfactions are met.