Patient‐Reported Outcomes and Esthetics of Single Dental Implants After 38.9 Years: A Cross‐Sectional Study
Jan Kowar, Sargon BarkarmoABSTRACT
Introduction
Long‐term evaluations of single dental implants have mainly focused on clinician‐reported outcomes, whereas patient‐reported and esthetic outcomes beyond 20 years remain sparsely documented.
Objective
To assess patient‐reported outcomes, peri‐implant soft‐tissue esthetics, and crown infraposition of single dental implants after a mean follow‐up of 38.9 years.
Materials and Methods
This cross‐sectional study included 13 patients with 18 single dental implants placed between 1982 and 1985 (mean follow‐up: 38.9 ± 0.8 years; range: 37.9–40.5 years). Patient‐reported outcomes were assessed using the Oral Health Impact Profile‐14 (OHIP‐14), the Orofacial Esthetic Scale (OES), and study‐specific Visual Analog Scale (VAS) evaluating overall treatment outcome, function, esthetics, and oral hygiene. Peri‐implant soft‐tissue esthetics were assessed using the Pink Esthetic Score (PES), with assessments conducted independently by two calibrated prosthodontists. Infraposition‐related incisal and cervical discrepancies were evaluated descriptively in six maxillary central‐incisor implant sites using intraoral scans or calibrated photographic analysis.
Results
The mean OHIP‐14 score was 18.1 ± 7.3. Mean VAS scores were 92.8 ± 9.0 for overall treatment outcome, 95.5 ± 6.9 for function, 80.9 ± 27.0 for esthetics, and 90.2 ± 14.5 for oral hygiene. The mean total OES score was 40.8 ± 20.5 ( n = 12; possible range: 0–80), with substantial interindividual variation. Mean total PES was 7.9 ± 2.2 and 8.6 ± 1.9 for the two observers. Interobserver reliability was assessed using the intraclass correlation coefficient (ICC), yielding an ICC of 0.47 (95% CI: 0.04–0.76). At all six assessable anterior implant sites, incisal and cervical discrepancies were observed, with the cervical discrepancy exceeding the incisal discrepancy in most cases.
Conclusion
After a mean of 38.9 years in function, the available single‐implant cohort reported high overall and functional satisfaction, while patient‐reported esthetic outcomes and professional peri‐implant soft‐tissue assessments were more variable. Incisal and cervical discrepancies were present in the small assessable anterior subgroup; because baseline esthetic measurements were unavailable, these cross‐sectional discrepancies cannot be attributed specifically to progressive infraposition.