Therapeutic Outcomes for Gingival Recession Defects in the Esthetic Zone: A Systematic Review

Background: The aim of this paper is to review the major quantitative and qualitative therapeutic outcomes for gingival recession defects in the esthetic zone. Methods: PubMed and MEDLINE were searched for entries up to April, 2012. For the assessment of quantitative parameters, criteria for considering studies for this assessment was based on the most current systemic review by Chambrone published in April, 2012. For the assessment of qualitative parameters, only studies that evaluated the soft tissue esthetic outcome of recession areas treated with root coverage procedures were included. Findings: Quantitative measurements of root coverage, such as percentage of root coverage and the percentage of gingival augmentation, provide objective assessment and the advantage of reliability. However, parameters that account for the global esthetic evaluation are not evaluated by the quantitative measurements. On the other hand, qualitative evaluation, such as scarring, texture, volume, color, gingival contour, and the location of mucogingival junction, is subjective and per se imperfect. It is limited to esthetic appearance and cannot replace the clinical quantitative assessment. More explicit criteria are required to improve the reliability of scales for esthetic assessment. Conclusions: The final esthetic goal of a root coverage procedure should include the achievement of complete root coverage and the complete soft tissue integration.