Aesthetics and Patient‐Reported Outcomes in Periodontology and Implant Dentistry: Consensus Report
Maurizio S. Tonetti, Mariano Sanz, Francesco Cairo, José Nart, Iain Chapple, Mario Aimetti, Sofia Aroca, Gustavo Ávila‐Ortiz, Juan Blanco, Antonio Bujaldón, Raffaele Cavalcanti, Pierpaolo Cortellini, Jan Cosyn, M. M. Danser, Massimo De Sanctis, Jan Derks, Henrik Dommisch, Elena Figuero, Rodolfo Gianserra, Filippo Graziani, Søren Jepsen, Moritz Kebschull, France Lambert, Eduardo Montero, Nadja Naenni, Ian Needleman, Andrea Pilloni, Aušra Ramanauskaitė, Mario Roccuzzo, Ignacio Sanz‐Martín, Ignacio Sanz‐Sánchez, Frank Schwarz, Anton Sculean, Martina Stefanini, Daniel S. Thoma, Leonardo Trombelli, Cristina Vallés, Nicola West, Giovanni Zucchelli, Otto Zuhr, David Herrera
Abstract
BACKGROUND: Aesthetics and patient-reported experiences (PREs) and outcomes (PROs) influence treatment choices, but have been largely overlooked in periodontology and implant dentistry. This consensus conference evaluated these factors by focusing on gingival recession defects (GRDs), immediate or early/delayed implant placement and peri-implant buccal soft-tissue dehiscences. METHODS: The workshop discussions were informed by five specifically commissioned systematic reviews covering PREs, PROs and clinician-reported outcomes (CROs), including effectiveness, aesthetics and other concerns. RESULTS: Following treatments such as coronally advanced flaps (CAFs) with a connective tissue graft (CTG) for root coverage (RC), a positive correlation was noted between clinician-reported aesthetic scores and RC measures for GRDs. However, a corresponding correlation for patient-reported aesthetic perceptions was not evident. In dental implant procedures, the addition of a CTG immediately after implant placement significantly mitigated the apical shift in the mid-facial mucosal level. However, clinician- and patient-reported aesthetic scores were not reflective of these changes. Neither set of scores captured the impact of grafting on improving peri-implant soft-tissue volume. In the treatment of peri-implant dehiscences, soft-tissue augmentation (STA), using CTG beneath CAF, resulted in favourable outcomes in clinician- and patient-perceived aesthetics. CONCLUSIONS: Clinician and patient views provide complementary perspectives for evidence-based clinical decision making. They need to be integrated into select interventions. Specific trials are needed encompassing PREs, PROs and CROs and reporting benefits and harms.