Aesthetic evaluation after root coverage procedure: level of agreement between clinical evaluation and patient satisfaction

Abstract

Introduction: Root coverage procedures are performed mainly by esthetic reasons. [1,2] The objective evaluation of the results by the dental practitioner may differ from the satisfaction expressed by the patient, resulting in a discrepancy between the objective measures performed and the subjective and individual interpretation of the patient. [3] The aim of the present study was to evaluate the relationship between the aesthetic evaluation of the dentist and patient satisfaction after a root coverage procedure.

Materials and methods: The clinical and aesthetic results of 10 surgical procedures of root coverage were evaluated. The clinical parameters analyzed were: plaque index (PI); gingival index (GI); probing pocket depth (PPD); bleeding on probing (BoP); height (HR) and width (WR) of recession; width of keratinized gingiva (WKG) and clinical attachment level (CAL) at the surgery appointment and later at 4 and 12 weeks. The aesthetic results were evaluated by the dentist according to the Root Esthetic Score (RES) and by the patient through a questionnaire of aesthetic satisfaction at 4 and 12 weeks. All the patients signed an informed consent and the study protocol was approved by Egas Moniz ethics committee, reference number 550. Data were subjected to statistical analysis using the following tests: Shapiro Wilk; ANOVA; Friedman; t Student; Wilcoxon and Spearman’s rho correlation with significant level (p < 0.05).

Results: There was a statistically significant improvement (ρ< 0,05) in the clinical parameters height of recession, width of recession, width of keratinized gingiva and clinical attachment level over time. The aesthetic evaluation performed by the dentist, showed a significant improvement (ρ< 0,05) through the two aesthetic evaluations performed (5,30 ± 2,36 vs 6,40 ± 2,84). In turn, the aesthetic evaluation of the patients maintained a constant value in these two moments. The Root Esthetic Score (RES) and the patient evaluation present a positive Spearman’s rho correlation (0,421 vs 0,316) in both evaluation periods, however this correlation was not significant (ρ > 0,05).

Discussion and conclusions: Periodontal surgery seems to improve clinical parameters as well as aesthetic assessment. The results tend to improve and stabilize along the follow-up period. [4] There is a positive correlation between the aesthetic evaluation performed by the clinician and the aesthetic evaluation of the patient.

Acknowledgements

The authors acknowledge all the support given by clinical direction of Egas Moniz Dental Clinic.