# Patient‐Reported and Clinician‐Reported Esthetic Outcomes at Implant Sites Are Not Associated: A Systematic Review With Individual Participant Data Meta‐Analysis

## TL;DR

This study found that how clinicians rate the appearance of dental implants doesn't match how satisfied patients are with their look.

## Contribution

The study is the first to use individual participant data from multiple trials to compare patient and clinician esthetic assessments of dental implants.

## Key findings

- At crown insertion, there was no significant correlation between clinician and patient esthetic ratings.
- At 1-year follow-up, the correlation was negligible and not statistically significant.
- At 10-year follow-up, no correlation was found between clinician and patient assessments.

## Abstract

This systematic review aimed to determine whether patient‐reported outcomes (PROs) are associated with clinician‐reported outcomes (ClinROs) in terms of esthetics in patients with single implant‐supported crowns in the esthetic region.

A systematic electronic search was conducted following a pre‐established protocol to identify randomized controlled trials (RCT) involving patients with single implant‐supported crowns in the esthetic region. Studies had to assess both patient‐ and clinician‐reported outcomes. A two‐stage individual participant data (IPD) meta‐analysis was conducted. First, each study was analyzed separately to obtain correlation coefficients. Second, these estimates were pooled using a random‐effects restricted maximum likelihood (REML) model.

A total of 29 RCTs evaluating 1414 implant‐supported crowns were included, with IPD available for 14 trials evaluating 675 patients. At crown insertion, IPD meta‐analysis from 171 patients across four RCTs showed no significant correlations (r = 0.11, 95% CI [−0.04; 0.27], p = 0.16) between pink esthetic score (PES) and patient satisfaction with esthetics assessed with visual analogue scale (VAS). At the 1‐year follow‐up, IPD from 502 patients in 11 studies showed a negligible positive correlation (r = 0.09, 95% CI [−0.00; 0.18], p = 0.06) between PES or modified PES and VAS esthetic satisfaction. At 10‐year follow‐up, data from 80 patients in two studies showed no correlation between modified PES and VAS patient satisfaction (r = −0.05, 95% CI [−0.37; 0.27], p = 0.75). Regarding white esthetic score (WES) and VAS satisfaction, data from 376 patients in seven studies showed no significant correlations at the 1‐year follow‐up (r = 0.03, 95% CI [−0.08; 0.13], p = 0.60).

Clinician‐reported outcomes, using PES and WES, showed no correlation with patient‐reported esthetic satisfaction, regardless of the follow‐up duration.

PROSPERO number CRD42023394920