Dental implants offer many benefits. They function just like natural teeth. They’re easy to care for. And they can last a lifetime.
But for many people, the big attraction of dental implants is that they can look just like natural teeth. People want a restoration that doesn’t just function naturally: it should make their smile look whole and beautiful. That’s what cosmetic dentists want, too. And we’re getting closer to developing a good standard to judging those implant aesthetics, too.
“Pink” Aesthetics and “White” Aesthetics
In a recent review of dental implant aesthetics, researchers noted that there are two separate areas of aesthetics that need to be evaluated, what they term the “pink” aesthetics and the “white” aesthetics.
Pink aesthetics refers to the soft tissue around the dental implant. This is affected by how well the gum tissue has grown up around the dental implant. The gum margin around the implant should be comparable to that around other teeth. It should create a smooth, scalloped curve, not look as if there are receding gums around the implant. Also important is the maintenance of the papilla: protrusions of the gums that are sandwiched between the crowns of teeth. These can be lost during implant procedure, but if they are lost, they will leave small black triangles that are highly visible. Because defects are so visible, this is one of the most important criteria in implant aesthetics.
White aesthetics refers to the replacement crown on top of the dental implant. This crown has to mimic the size, shape, coloration, and luster of natural teeth.
Objective Aesthetics Measurements
Most studies of dental implant aesthetics try to develop some kind of objective measurement system. This would allow for verifiable results that can be directly compared between studies. Many pink aesthetics standards have been developed. The level of the gums can be measured from an objective reference point, such as the cusp of the restoration, the cusps of the teeth, the cemento-enamel junction, or even reference marks on a standardized stent. Other times, the measurements are compared to a reference tooth site.
Specific standards proposed for the papilla include comparison with natural teeth, the distance from the cusp of the teeth, or a simple numerical rating from 0-4 based on the percent of the gap filled by the papilla.
Another concern is for the color of the gum tissue around the implant. If the gums are discolored, showing grey from the implant through the soft tissue, then the result will be neither as attractive nor as natural as we desire. Spectrometers can be used to precisely measure the color difference between the gum tissue around implants and that around natural teeth. These measurements aren’t necessarily relevant, because they are more precise than people can discern or care about.
These systems are also used for the perception of the dental crown, with similar results: the spectrometer can tell differences more precisely than concerns people.
Overall, these measurements can be assembled together into a seven- or 10-item assessment that seems to work as an objective measure of implant aesthetics.
But do these objective measurements really tell us what we need to know? We really care whether the implant is attractive and makes the recipient happy with their appearance. To assess this, we can employ what are known as subjective measurements. This means asking people simply if they’re happy with the appearance of their implants. This isn’t so good for comparing between studies, but it does reveal several interesting facts:
- Overall, people are happy with the appearance of their implants
- Dentists are more critical of implant appearance than patients
- Patients and dentists generally agree about the appearance of the crown
- Dentists are much more critical of the pink aesthetics of a dental implant
- Good aesthetics are harder to achieve when a single implant is placed among natural teeth
These insights help us judge where we really need to be careful in dental implant treatment. Dental crowns have been largely perfected as a tooth restoration, and they translate to performing the same role on dental implants. Soft tissue regrowth is a challenge more unique to dental implants, so we are still learning how best to manage.
What Do You Think of Our Results?
When it comes to implant aesthetics, you can judge for yourself the quality of results we are able to achieve. Check out our Smile Gallery, which includes many people whose smiles have been restored with dental implants.