Abstract: Objective： To evaluate the soft tissue esthetic outcome of implant restored anterior teeth lost from periodontal destruction. Methods: In the present study, 20 teeth extracted for severe periodontal destruction from 15 patients were involved. All the recruited patients received initial periodontal therapy. The implants were inserted with routine flap surgery 2-3 months after teeth extraction, and the guided bone regeneration technique was used when indicated. The extent of alveolar bone deficiency and the depth of implant placement (the distance from implant shoulder to the line connecting cemento-enamel junction of mesial and distal neighbor teeth) were recorded. The second-stage exposure and restoration were conducted after 3-month sub-mucosal healing. Pink esthetic score (PES) was used to evaluate the soft tissue esthetic outcome 1-3 months after final restoration. Results: All the implants obtained osseointegration successfully. The mean PES value was 9.6±2.4, ranging from 5 to 13. The PES values of the 3 prostheses were lower than 7. The mean PES value of the 13 sites with only horizontal bone defect was 10.5±1.9, and was significantly higher than that of the 7 sites with combined horizontal and vertical bone defect (7.9±2.3, P<0.05). The negative correlation was observed between the PES value and depth of implant placement (r=-0.608, P<0.01). Conclusion: High esthetic risk exists when restoring missing teeth lost from periodontal destruction by implant treatment. Alveolar bone defect especially vertical bone loss may mainly contribute to the soft tissue esthetic outcome deficiency.

Key words: Periodontitis, Dental implantation, Esthetics, dental