Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium.
Faculty of Medicine and Pharmacy, Oral Health Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Clin Oral Implants Res. 2021 Oct;32 Suppl 21:93-107. doi: 10.1111/clr.13756.
The primary objective was to provide an overview of soft tissue metric parameters, methods, and aesthetic indices in implant dentistry. The secondary objective was to describe reliability and validity of aesthetic indices.
Two independent reviewers conducted an electronic literature search in Pubmed, Web of Science, Embase, and Cochrane databases up to October 2020 to identify studies on soft tissue metric parameters, methods, and aesthetic indices. Aesthetic indices were evaluated in terms of reliability and validity. Data extraction was performed by the same reviewers.
Five metric parameters (papilla height, linear changes in soft tissue level, color assessment, soft tissue thickness, and profilometric soft tissue changes) registered by means of several methods (intra-oral registrations, radiographic assessments, digital analyses, and ultrasonic assessments), and 15 aesthetic indices (Papilla Index (PI), ad hoc questions scored with Visual Analogue Scales, Pink Esthetic Score (PES), Implant Crown Aesthetic Index (ICAI), Implant Aesthetic Score (IAS), Rompen Index, Subjective Esthetic Score, White Esthetic Score, Copenhagen Index, Complex Esthetic Index, Californian Dental Association Index (CDAI), Peri-Implant, and Crown Index, Functional Implant Prosthodontic Score, Implant Restoration Esthetic Index (IREI), and Mucosal Scarring Index (MSI)) could be identified. With respect to metric parameters and methods, intra-oral registrations were least accurate whereas profilometric soft tissue changes on the basis of digital surface models were most accurate. Six aesthetic indices showed good inter-rater reliability (PI, PES, ICAI, CDAI, IREI, and MSI). Good validity could only be shown for two indices (PES and CEI). Given this and on the basis of ease of use and ease of interpretation, PES qualified best for clinical research on single implants. None of the indices fulfilled the quality criteria for clinical research on multiple implants.
Many soft tissue assessment methods with varying reliability and validity have been described and used, which hampers uniform reporting in implant dentistry. Clinical investigators are advised to measure linear and profilometric soft tissue changes using digital surface models, and to use a reliable and validated aesthetic index. Currently, PES qualifies best for aesthetic evaluation of single implants. An index is to be developed to assess the aesthetic outcome of rehabilitations on multiple implants.
本文旨在概述种植体牙科中软组织计量参数、方法和美学指数，并描述美学指数的可靠性和有效性。
两名独立的审查员对 Pubmed、Web of Science、Embase 和 Cochrane 数据库进行了电子文献检索，以查找截至 2020 年 10 月有关软组织计量参数、方法和美学指数的研究。从可靠性和有效性两个方面评估美学指数。由同一名审查员进行数据提取。
通过多种方法（口腔内记录、放射评估、数字分析和超声评估）记录了 5 个计量参数（牙乳头高度、软组织水平的线性变化、颜色评估、软组织厚度和轮廓软组织变化）和 15 个美学指数（牙乳头指数（PI）、采用视觉模拟量表评分的专门问题、粉红色美学评分（PES）、种植体冠美学指数（ICAI）、种植体美学评分（IAS）、Rompén 指数、主观美学评分、白色美学评分、哥本哈根指数、复杂美学指数、加利福尼亚牙科协会指数（CDAI）、种植体周围、冠指数、功能性种植体修复美学评分、种植体修复美学指数（IREI）和黏膜瘢痕指数（MSI））。就计量参数和方法而言，口腔内记录的准确性最低，而基于数字表面模型的轮廓软组织变化的准确性最高。6 个美学指数显示出良好的组内一致性（PI、PES、ICAI、CDAI、IREI 和 MSI）。仅 PES 和 CEI 两个指数具有良好的有效性。基于此，以及使用的便利性和易于解释性，PES 最适合单牙种植体的临床研究。没有一个指数符合多牙种植体临床研究的质量标准。
描述并使用了许多具有不同可靠性和有效性的软组织评估方法，这阻碍了种植体牙科中统一的报告。临床研究人员建议使用数字表面模型测量线性和轮廓软组织变化，并使用可靠和经过验证的美学指数。目前，PES 最适合单牙种植体的美学评估。需要开发一个指数来评估多牙种植体修复的美学效果。
