The Cologne Smile Check: Development and validation of a patient-reported outcome measure for esthetic assessment of prosthetic tooth color

<title>Abstract</title> <p>Background Patient-reported outcome measures (PROMs) are increasingly used to complement clinical evaluation in prosthetic dentistry. No PROM specifically assesses patient satisfaction with prosthetic tooth color. This study aimed to perform the initial psychometric evaluation of the newly developed Cologne Smile Check (CSC), a color-specific PROM for prosthetic treatment. Methods In this retrospective longitudinal validation study, adult patients receiving fixed or removable prosthetic treatment completed the CSC and the validated German version of the Orofacial Esthetic Scale (OES-G) before treatment and approximately one week after insertion of the restoration. Internal consistency, construct validity, discriminant validity, and responsiveness to treatment were evaluated. Results Thirty-five patients completed both assessments. The CSC demonstrated acceptable internal consistency (Cronbach's α = 0.76; McDonald's ω = 0.79). Construct validity was supported by moderate to strong positive correlations with the OES-G, with the strongest association observed between corresponding tooth color items (ρ = 0.66, P &lt; 0.001). Correlations with unrelated esthetic domains were significantly weaker, supporting discriminant validity. Patient-reported satisfaction with prosthetic tooth color improved significantly following treatment, and changes in CSC scores correlated moderately with changes in the OES-G, indicating that both instruments assess related but distinct aspects of esthetic treatment outcomes. Conclusion The CSC may represent a standardized instrument for assessing patient satisfaction with prosthetic tooth color, complementing existing generic PROMs by capturing a color-specific aspect of esthetic treatment outcomes. These initial findings are encouraging, but further validation in larger and more diverse patient populations is required.</p>