A comparison of methods of aesthetic assessment in root coverage procedures

Kerner S, Katsahian S, Sarfati A, Korngold S, Jakmakjian S, Tavernier B, Valet F, Bouchard P. A comparison of methods of aesthetic assessment in root coverage procedures. J Clin Periodontol 2009; 36: 80-87. doi: 10.1111/j.1600-051X.2008.01348.x. To evaluate the reliability of professional qualitative scoring methods used in evaluating aesthetic results after root coverage therapy and to evaluate the relationship between subjective and objective measurements. A review panel of seven professional and non-professional, trained and untrained observers used photographic records to assess the overall cosmetic results of 162 root coverage surgical procedures in 133 patients (mean follow-up 17.51 +/- 17.37 months). Two different methods were used. In the before-after panel scoring system, observers evaluated the difference between preoperative and postoperative views, whereas in the random panel scoring system, observers rated each photograph independently. For both methods, intrarater agreement ranged from substantial to almost perfect for the periodontists. The best interrater agreement was found for trained periodontists using the five-point ordinal scale of the before-after panel scoring system (kappa=0.68). Neither root coverage percentage nor gingival augmentation was correlated to cosmetic assessment. The before-after scoring system is an acceptable and reliable method for professional cosmetic assessment of root coverage therapy. The overall cosmetic evaluation does not appear to be related to the percentage of root coverage.