Aesthetic rehabilitation in implant prosthodontics: current concepts, digital advances and clinical perspectives: a narrative review

Rohit Raghavan; Shajahan P. A.; Akash R.

doi:10.18203/2320-6012.ijrms20263259

Authors

Rohit Raghavan Department of Prosthodontics and Crown & Bridge, Royal Dental College, Chalissery, Kerala, India
Shajahan P. A. Department of Prosthodontics and Crown & Bridge, Royal Dental College, Chalissery, Kerala, India
Akash R. Department of Prosthodontics and Crown & Bridge, Royal Dental College, Chalissery, Kerala, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20263259

Keywords:

Aesthetic implant prosthodontics, Dental implants, Implant aesthetics, Digital dentistry, Peri-implant soft tissue, CAD/CAM, Pink esthetic score, White esthetic score, Digit

Abstract

Aesthetic rehabilitation in implant prosthodontics is an integral component of contemporary dental practice, with treatment success determined not only by implant survival but also by restoration of natural function, appearance, and patient satisfaction. Predictable aesthetic outcomes require a prosthodontically driven approach involving comprehensive diagnosis, accurate three-dimensional implant positioning, and preservation of peri-implant hard and soft tissues. Factors such as smile line, periodontal phenotype, bone morphology, implant position, emergence profile, and restorative material selection influence the final aesthetic outcome. Thorough preoperative assessment facilitates identification of risk factors and individualized treatment planning. Digital technologies, including cone-beam computed tomography (CBCT), digital smile design, intraoral scanning, computer-aided design and manufacturing (CAD/CAM), and computer-guided implant surgery, have improved diagnostic accuracy, treatment planning, restorative precision, and interdisciplinary communication. The Pink Esthetic Score (PES) and White Esthetic Score (WES) provide standardized methods for evaluating peri-implant soft-tissue and prosthetic aesthetics. Soft-tissue augmentation, customized healing abutments, and immediate provisionalization may further enhance peri-implant tissue management and aesthetic outcomes in appropriately selected cases. However, complications such as mucosal recession, papillary deficiency, inadequate soft-tissue volume, and unfavourable emergence profiles remain challenging. Predictable aesthetic rehabilitation therefore requires an interdisciplinary, evidence-based approach integrating biological principles, prosthodontic concepts, and contemporary digital technologies to achieve functionally sound, biologically stable, and aesthetically harmonious implant-supported restorations.

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