3-D tooth movement adjacent to single anterior implants and esthetic outcome. A 14-20-year follow-up study.

Abstract

OBJECTIVES\nTo report three-dimensional (3-D) movement of teeth adjacent to single implants crowns (SICs) in the anterior maxilla and to relate the findings to patient characteristics and esthetic outcome.\n\n\nMATERIALS AND METHODS\n3-D movements of teeth adjacent to anterior maxillary SICs were measured in 30 patients with original SICs in function after 14-20 years. The movements were related to facial type, lower anterior facial height (LAFH), age at crown delivery, sex, the position of the implant, implant occlusion, cause of tooth loss, follow-up period, orthodontic treatment prior to implant placement and marginal bone level changes. The esthetic outcome and quality were assessed using Visual Analogue Scale (VAS) and California Dental Association index (CDA).\n\n\nRESULTS\n3-D movement of adjacent teeth between 0-2.5 mm was observed at follow-up with incisal and palatal movement being most pronounced. Incisal tooth movement of > 1 mm was observed in 30 % of the patients and was significantly associated with LAFH ≥ 70 mm. VAS rating associated poorly between patients and clinicians with scores of > 80% in 63% and 20%, respectively. The CDA rating was assessed as satisfactory in 87% of the patients.\n\n\nCONCLUSIONS\nSignificantly more extensive infraposition was observed in patients with SICs without occlusion, other causes of tooth loss than trauma, implant in lateral incisor and canine position and a LAFH of ≥ 70 mm. Although infraposition occurs, patients are highly satisfied with the esthetics of their implants and the esthetic results are valued as higher by patients than dentists.