Validation of the modified Pink Esthetic Scores for single implant esthetic evaluation using intraoral scanning data

PURPOSE: To evaluate the feasibility of esthetic evaluation using modified Pink Esthetic Scores (PES) criteria based on the intraoral scanning data. MATERIALS AND METHODS: The PES criteria were refined for esthetic assessment of implant-supported restorations using standardized scanning images. Compared to classic PES, the variables remained unchanged, while 0.5 and 1.5 intervals were added for subtle details. In addition, the assessment of esthetic variables was based on measurement and calculation of soft tissue features. Forty samples were included and independently evaluated according to the classic and modified criteria by three dentists with different levels of clinical experience with an interval of 2 months. RESULTS: The mean classic and modified PES were 9.28 ± 2.38 and 8.93 ± 2.12, respectively. The consistency between observers using the classic and modified PES criteria reached 0.790 and 0.856, respectively. The scores from the postgraduate student were significantly lower when evaluating the samples with the modified PES, while no significant difference could be observed for the two senior dentists. The alveolar process and soft-tissue texture were the only two variables with a significantly lower score when applying the modified PES. CONCLUSIONS: The modified PES served as a practical tool to decrease the discrepancy between multiple observers with different seniorities. Further automated tools are required to increase the efficiency of esthetic evaluation.