Question4. “How do you feel about the color of the gum that is around your new implant tooth?” Mean patient rating was calculated as 8.4 (range 2–10, SD ± 2.0). Median score was 9. Fifteen patients responded with a score of ≥ 8 and 17 patients responded with a score of ≥ 6.

Question5. “What is your overall satisfaction with the new implant tooth?” Mean patient rating was calculated as 8.8 (range 5–10, SD ± 1.6). Median score was 9. Sixteen patients responded with a score of ≥ 8 and 17 patients responded with a score of ≥ 6.

Spearman’s correlation test failed to show any significant associations between the overall mean VAS results and PES or WES (p = 0.475, p = 0.984, respectively) (Table 4).

Majority of the patients (13 out of 19) were found to have thick gingival biotype and 6 patients had thin gingival biotype. When these patients were evaluated according to their gingival biotypes, those with thin and thick biotypes had mean PES values of 9.83 (range 5–13, SD ± 3.43) and 11.23 (range 8–13, SD ± 1.36), respectively. WES for thin and thick-biotyped patients were found to be 8.67 (range 8–9, SD ± 0.52) and 8.62 (range 8–10, SD ± 0.65), respectively. PES and WES scores for each group of patients (i.e., thin and thick biotypes) failed to show any statistically significant difference (p = 0.701, p = 0.831; Mann-Whitney U test).

Low, medium, or high smile lines were determined in four, ten, and five patients, respectively (Table 5).

There was a significant negative correlation between the smile line and VAS; meaning that patients with lower smile lines expressed higher patient satisfaction (p = .001, Spearman’s correlation analysis) (Table 6).

Type 2 (early, with soft tissue healing) and type 3 (early, with partial bone healing) placement protocols were followed for five implants each, whereas type 4 (late, with complete bone healing) placement was the most common protocol accounting for nine of the implants. Immediate implant placement (type 1) was not utilized in any patient. PES and WES for different placement protocol groups (i.e., type 2, 3, or 4) failed to show any statistically significant difference (p = 0.296, p = 301 respectively; Kruskal-Wallis test).