Validation of the pink esthetic score/white esthetic score at single tooth-supported prostheses in the esthetic zone: A randomized clinical trial

Sreeprada Dash; Gunjan Srivastava; Subrat Kumar Padhiary; Monika Samal; Gülce Çakmak; Andrea Roccuzzo; Pedro Molinero-Mourelle

doi:10.1111/jerd.13243

Validation of the pink esthetic score/white esthetic score at single tooth-supported prostheses in the esthetic zone: A randomized clinical trial

J Esthet Restor Dent. 2024 Apr 30. doi: 10.1111/jerd.13243. Online ahead of print.

Authors

Sreeprada Dash¹, Gunjan Srivastava¹, Subrat Kumar Padhiary², Monika Samal¹, Gülce Çakmak³, Andrea Roccuzzo⁴, Pedro Molinero-Mourelle³

Affiliations

¹ Department of Prosthodontics, Institute of Dental Sciences, Bhubaneswar, India.
² Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bhubaneswar, India.
³ Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland.
⁴ Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.

PMID: 38689391
DOI: 10.1111/jerd.13243

Abstract

Objectives: To validate the reproducibility and inter/intra-observer variability of the Pink Esthetic Score/White Esthetic Score (PES/WES) of single tooth-supported prostheses in the maxillary esthetic zone (13-23).

Materials and methods: Forty-five patients were randomly assigned to one of the three treatment options (15 patients per group) receiving each one a different crown type: Porcelain fused to metal (PFM), monolithic zirconia, and lithium disilicate. Eight observers from each of four different specialties (Prosthodontists, Orthodontists, Periodontists, and Oral Surgeons) were recruited and assessed twice and four weeks apart (i.e., T1 and T2) 45 photographs of the single tooth-supported prosthesis using PES/WES and compared them with contralateral teeth.

Results: According to the ANOVA and post hoc tests, the zirconia crown type obtained the highest mean score by all observers, with a mean value of 16.70 ± 2.94. The prosthodontists and oral surgeons assigned the lowest mean score to PFM crowns, 13.03 ± 3.47 and 13.80 ± 3.17, respectively. Notably, the prosthodontists awarded the highest scores, specifically 17.50 ± 2.81 for the zirconia crowns. Intraobserver agreement was calculated utilizing the paired t-test. Pairwise comparisons between observers of different specialties revealed significant intraobserver agreement. Interclass correlation coefficient (ICC) scores were statistically significant among four specialties. No difference was detected concerning the interobserver agreement.

Conclusions: The PES/WES index remains consistent across various observers from different specializations, yielding uniform results in the overall esthetic evaluation. Consequently, in light of the presented preliminary positive results, its use might also be considered for the esthetic assessment of single-tooth-supported prostheses.

Clinical significance: The PES/WES index may be employed clinically to evaluate single tooth-supported prostheses as it emerged as a reproducible esthetic scoring system.

Keywords: PES/WES; anterior maxilla; esthetic evaluation; fixed dental prosthesis.