The two main goals of dental implant therapy are to restore function and esthetics, that is to enable patients to chew and smile again by replacing missing teeth with titanium or ceramic implants. Whereas it is relatively straightforward to assess osseointegration in daily clinical routine by either tapping on implants or using more sophisticated methods such as stability indices like ISQ values, esthetics is more complicated to measure. There is no generally accepted diagnostic tool to help in the evaluation of the esthetic outcome, and feedback from patients is known to be quite subjective and often not aligned with the clinician’s perception. Facial attractiveness is also a relevant and timely topic in many other fields in dentistry, and even artificial intelligence (A.I.) has been used to address this. A recent study used A.I. tools to determine the influence of dental esthetics on facial attractiveness in comparison to other facial modifications such as lipstick or wearing glasses (Obwegeser et al. 2022). Interestingly, this study has shown that convolutional neural networks can be trained to reliably assess the impact of tooth alignment and facial modifications on facial attractiveness, and also that alignment of upper front teeth improves facial attractiveness significantly, but frustratingly only to a degree comparable to wearing lipstick. Thus, assessing factors that influence the esthetic outcome, and also the analysis of the final results regarding esthetics is challenging, and also not that easy to objectively summarize when trying to tackle this topic with a more evidence-based approach.
Nevertheless, the Editorial Board of Forum Implantologicum has taken up this challenge and has dedicated an entire issue to “Esthetics in Implant Dentistry”. Over the coming months, articles on various aspects of esthetics will be published at regular intervals. Prof. Leesungbok and his team are presenting an overview of relevant variables for esthetic and functional outcomes of dental implant prostheses for elderly disabled patients. The article by Dr. Marchand et al. aims to highlight the advantages as well as the current limitations of zirconia as an implant restoration material specifically known for its “esthetic” characteristics. Prof. Gallucci, Dr. Pedrinaci and co-authors provide you with clinical variables contributing to esthetic and biological success in implant prosthodontics of the anterior zone as well as key treatment considerations on the decision-making process of replacing missing anterior teeth. Finally, Prof. Wittneben and co-workers summarize the current status of the assessment of the esthetic outcome for dental implant restorations including an overview of available esthetic indices.
Please take the time to come back again and again to enjoy all of these articles that offer many relevant insights, practical tips as well as food for thought that will ideally result in a direct impact on your practice.
My best regards,
Michael Bornstein