Aesthetic Evaluation Of Gingival Induction During The Period Of The Maxillary Anterior Single-tooth Implants Second-stage Surgery

ObjectiveTo evaluate the esthetic outcomes of the maxillary anterior single-tooth implant by comparing whether the implant-supported temporary prostheses was used to induce the gingiva during the period of second-stage surgery,observing the relevant indicators of implant aesthetic restoration and patients' satisfaction,analyzing the correlation,so as to provide reference for clinical practice.Methods60 patients of single anterior teeth deletion were divided into two group A and B randomly according to the inclusion criteria before surgery,30 patients in each group.The patients in group A used implant-supported temporary crown during the period of second-stage surgery,while those group B used healing abutment during the period of second-stage surgery.The retention rates of implants,temporary crowns and healing abutments were counted.The aesthetic effect of soft tissue in group A and B were evaluated immediately and 1 year after permanent restoration by pink esthetic score(PES).White esthetic score(WES)was used to evaluate the aesthetic effect of crown in A and B groups 1 year after permanent restoration,and the subjective satisfaction of patients was measured by visual analog scale(VAS).The aesthetic effects of the two groups were evaluated and the correlation between PES and WES,VAS and PES,VAS and WES was analyzed.ResultsThe retention rate of implants,temporary crowns and healing abutments was 100%.At the moment of permanent restoration,The mean value of PES(8.03±1.10)in Group A was higher than that of Group B(6.90±1.21),and the difference was significant statistically(P=0.00,P<0.05);1 year later,The mean value of PES mean(8.20±0.96)in Group A was still higher than that in Group B(8.07±1.05),and the difference was not statistically significant(P=0.51,P>0.05).The value of PES in Group A has no statistically significant difference between the permanent restoration immediately and 1 year later(P=0.10,P>0.05),but the PES difference was statistically significant in Group B(P=0.00,P<0.05).In Group A,the WES with an average value of(8.10±0.40)and the mean value of VAS was(8.68±0.54);In Group B,the WES with an average value of(8.03±0.61)and the mean value of VAS was(8.45±0.40).In Group A,PES value and WES value were significantly positive correlation(r=0.90,P<0.05),and there was a positive correlation between VAS value and PES value,VAS value and WES value(r = 0.93,P < 0.05;r = 0.81,P < 0.05);In Group B,PES value and WES value were significantly positive correlation(r=0.84,P<0.05),and there was a positive correlation between VAS value and PES value,VAS value and WES value(r = 0.86,P < 0.05;r = 0.76,P < 0.05).ConclusionUsing implant-support temporary crown to induce gingiva during the maxillary anterior single-tooth implants second-stage surgery can obtain better soft tissue esthetic outcomes faster than using the healing abutment alone,and the aesthetic effect is stable and reliable in the short term,and patients' satisfaction is also higher.PES and WES will affect each other,but also affect the satisfaction of patients,the three complement each other.When using implant-supported temporary prostheses for gingiva induction in the second-stage of implant surgery,doctors need to grasp the indications strictly and standardize the operation process carefully,the ideal aesthetic effect depends on the maintenance of hard and soft tissues,which is inseparable from minimally invasive surgery and fine restoration process.