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Patient-Reported Outcomes and Esthetics of Single Dental Implants After 38.9 Years: A Cross-Sectional Study
Jan Kowar1,2, Sargon Barkarmo1,2
1Brånemark Clinic, Public Dental Health Care Service, Gothenburg, Sweden.
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.