EVALUATION OF THE AESTHETIC OUTCOME OF MUCOGINGIVAL ROOT COVERAGE TECHNIQUES

Aim: as aesthetic demands in mucogingival surgery have in- creased, the Root coverage Esthetic Score (RES) was intro- duced to assess esthetic outcomes. However, gingival color evaluation remains subjective. This study aimed to enhance objectivity by modifying the RES through spectrophotometric analysis, as advocated by Gomez Polo, and to assess the im- pact of clinical variables on esthetic results. Methods: twelve patients treated with root coverage surgery in the past 10 years were selected. Each site was evaluated using both the traditional RES and a modified version using a spectrophotometer. Gingival color was assessed by compar- ing treated and adjacent sites using L*, a*, and b* values. A ΔE ≥1 indicated visible color difference (score 0); ΔE <1 indicated no perceptible difference (score 1). Additional data on reces- sion type, tooth site, smoking, hygiene, gingival thickness, and patient satisfaction were collected. Results: the modified RES yielded slightly lower scores, as the spectrophotometer detected ΔE ≥1 in all cases. Treated sites were lighter and less red, suggesting increased keratinization. Esthetic outcomes were classified as success (RES = 10), par- tial success (4-9), or failure (≤3). Failures were associated with undetectable CEJ, mandibular sites, smoking, poor hygiene, and thin gingiva. Conclusions: the traditional RES is adequate in clinical set- tings, as patients don’t perceive minor color differences. How- ever, spectrophotometry revealed subtle changes and poten- tial keratinization, supporting thicker grafts in challenging sites for improved outcomes.