Evaluation of soft-tissue alteration around implant-supported single-tooth restoration in the anterior maxilla: the pink esthetic score

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To evaluate the alterations of soft tissue around a single-tooth implant in the anterior maxilla with a new defined pink esthetic score (PES) at the time of crown placement and 6 months post-loading.

Material and methods

According to the case inclusion criteria, 29 patients subjected to single-tooth replacement with ITI implant-supported restoration in the anterior maxilla were included. Assessments of soft tissue after crown placement (baseline) and at 6 months (follow-up) were performed by two orthodontists with PES.


No statistically significant difference was found between the two observers. PES for the single-tooth implant varied from 6.90 to 9.55 at 6-month follow-up. The scores of the mesial and distal papilla, level of soft-tissue margin, soft-tissue contour, soft-tissue color and soft-tissue texture increased significantly at follow-up. The highest percentage of improvement in PES was found in the cases scoring 0–4 at the baseline.


The esthetic outcome of soft tissue around the single-tooth implant had improved significantly at follow-up compared with baseline according to PES assessment. The results suggested that the potential for significant changes in soft-tissue levels after restorative therapy needs to be considered for single-implant therapy in the anterior maxilla.

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