Upper premolar region as aesthetic zone II in dental implant replacement: A five-year retrospective study

Background: Aesthetic zone refers to maxillary anterior region, from canine to canine, which is important in smile aesthetics. However, based on smile width, this area may be extended to include premolars. The aim of this study was to navigate the aesthetic zone of the upper premolar region for dental implant treatment. Methods: This study was conducted at a private dental center in Baghdad. Dental implant cases treated between January 2018 and April 2023 were included in the study. One hundred and ninety-six patients were included in the study. The demographic data, surgical information, dental implant zones, anterior aesthetic, premolars, and molar non-aesthetic zones, were recorded. Patients with incomplete data were excluded from the study. Descriptive and inferential statistics were implemented. The chi-square test was used to determine the relationship between nominal study variables. Results: The male-to-female ratio was 1:2. The highest percentage of implant replacement was found in the upper premolar region (28.7%), followed by the lower molar (23.6%), and the upper anterior aesthetic zone: the upper incisors (16.1%), and the upper canines (3.4%). Early success rate was approximately equal in the anterior, premolar, and other zones, but with the highest value in the premolar area (94%). Conclusion: There is a high demand for upper premolar implants by both genders compared to the aesthetic zone. This highlights the peculiarity of this zone and underpins the suggestion for classifying the upper premolar zone as aesthetic zone II.