Journal of Shanghai Jiao Tong University (Medical Science) ›› 2022, Vol. 42 ›› Issue (5): 602-608.doi: 10.3969/j.issn.1674-8115.2022.05.007

• Clinical research • Previous Articles     Next Articles

Reliability and accuracy analysis of root coverage esthetic score

SUN Wentao(), XIE Yufeng(), SHU Rong   

  1. Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
  • Received:2022-03-25 Accepted:2022-04-18 Online:2022-05-28 Published:2022-05-28
  • Contact: XIE Yufeng;
  • Supported by:
    National Natural Science Foundation of China(81991500);Innovative Research Team of High-level Local Universities in Shanghai(SSMUZDCX20180900);Clinical Research Program of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine(JYLJ201819);Natural Science Foundation of Shanghai(18ZR1422400)

Abstract: Objective

· To evaluate the reliability and accuracy of the root coverage esthetic score (RES) in clinical applications by comparing RES and the visual analogue scale (VAS) results after root coverage procedures.


· Thirty-two patients who visited the Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January to December 2020 with a total of 105 gingiva recessions were enrolled in this study. All gingiva recessions were treated with envelope technique combined with connective tissue graft (CTG). The patients' periodontal conditions were examined 6 months after surgery and the esthetic results were scored by 2 periodontists through RES and patients themselves through VAS. Intraclass correlation coefficient (ICC) and 95% confidence interval (95% CI) were used to represent the consistency of physician RES results. The differences of keratinized gingiva (KG) and gingival recession (GR) at baseline and 6 months after surgery were compared by using t-test. Analysis of variance was used to test the differences of each index among different VAS grades. Linear regression analysis was used to evaluate the relationship between percentage of root coverage (PRC) and VAS, RES and VAS. Multiple linear regression analysis was carried out with VAS as the outcome variable and 5 indexes of RES as independent variables. All tests were bilateral tests. The difference was statistically significant when P<0.05.


·In this study, KG increased by (1.19 ± 1.28) mm and GR decreased by (1.77±1.21) mm 6 months after surgery. The average PRC was 81.4%±39.9%, and the percentage of complete root coverage (PCRC) was 69.5%. There was no significant difference between the RES scores of the 2 periodontists (ICC=0.95, 95%CI 0.92?0.96). KG (P=0.008), PRC(P=0.000) and PCRC (P=0.000) varied significantly between different VAS grades. The RES and VAS scores were linearly correlated (P=0.000). Multiple linear regression analysis showed that VAS scores were linearly correlated with gingival margin (GM), soft tissue texture (STT) and muco-gingival junction (MGJ) (P=0.000, P=0.000,P=0.006).


· To a certain extent, the results of RES are consistent with the patient's esthetic judgment.

Key words: root coverage procedure, envelop technique, connective tissue graft, root coverage esthetic score, visual analogue scale

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