Assessment and aesthetic impact of a long-term vertical discrepancy between the single anterior maxillary implant-supported crown and adjacent teeth: A retrospective cross-sectional study

Abstract

Objectives: To assess the vertical discrepancy between implant-supported crowns and adjacent teeth in the maxillary anterior region at least 8 years after implant placement and to evaluate the influence of this discrepancy on the level of aesthetic awareness of patients.

Material and methods: The sample consisted of 23 adult individuals evaluated at least 8 years after placement of an implant-supported central or lateral single tooth-fixed partial denture. Patients had their crowns delivered at a mean age of 47.8 years (range: 18.9-65.8). The vertical discrepancy was measured by comparing initial and follow-up periapical radiographs using the implant as a stable structure. The patients' satisfaction with their anterior teeth condition and awareness of the possible vertical problem were evaluated using a questionnaire. The aesthetic outcome and patient awareness were related to the objective measurement of the vertical discrepancy.

Results: The implant showed a mean infraocclusion of 0.62 mm (range: 0.15-1.63 mm). The vertical discrepancy was not associated with the patient's gender, age at implant placement, and duration between initial and recall radiograph. Patients were generally satisfied with the long-term aesthetic outcome of their smile (mean: 3.9 on a 1-5 scale, 1 unsatisfied, and 5 completely satisfied). Out of 23 patients, 8 noticed the implant infraocclusion and 4 of them found the problem severe enough to be willing to improve the situation. The amount of vertical discrepancy was not associated with the patient's perception of the discrepancy and the pink aesthetic score.

Conclusion: Implant-supported crowns in the anterior region may suffer infraocclusion over the long term. The amount of vertical discrepancy was not dependent on the gender and age of the patient. Patients were generally satisfied with the aesthetic result of the restoration. The amount of vertical discrepancy, at least in the range we have measured, was not perceived by the patients as a complication.

Keywords: infraocclusion; single maxillary anterior implant; smile satisfaction; vertical changes.