{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T19:17:51Z","timestamp":1787858271181,"version":"build-2784847793"},"reference-count":70,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":225,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Periodontology 2000"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multiple gingival recessions can lead to esthetic impairments and may require surgical root coverage. Esthetic outcome measures can be assessed from both professional and patient perspectives. Several objective and subjective outcome measures have been applied for these evaluations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To systematically review and conduct a meta\u2010analysis of the available literature on professional esthetic assessments and patient\u2010related outcome measures (PROMs) following surgical root coverage procedures for the treatment of multiple gingival recessions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A computerized systematic search was conducted in the MEDLINE (via PubMed), EMBASE, and Cochrane Central Register of Controlled Trials databases up to May 2024 to identify eligible studies meeting the inclusion criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 32 randomized controlled trials involving 1012 patients and 3589 multiple gingival recessions were included. No case\u2010series studies meeting the inclusion criteria were retrieved. Meta\u2010analyses demonstrated that root coverage procedures statistically significantly improved both professionally assessed and patient\u2010reported esthetic outcomes. The overall weighted mean Root Coverage Esthetic Score (RES) was 8.31 (95% CI: 8.11\u20138.50), with comparable results across coronally advanced flap (CAF) and tunnel (TUN) techniques, particularly when combined with autogenous connective tissue grafts or graft substitutes. Patient\u2010reported esthetic satisfaction, measured primarily by visual analog scales (VAS), showed a pooled mean of 8.59 (95% CI: 8.29\u20138.89). Mean root coverage (MRC) reached 82.6% (95% CI: 71.3\u201393.9), and complete root coverage (CRC) was 62.7% (95% CI: 57.0\u201368.4). Statistically significant reductions in recession depth (mean difference\u2009=\u20092.22\u2009mm) and gains in keratinized tissue (0.74\u2009mm), gingival thickness (0.56\u2009mm), and clinical attachment level (2.17\u2009mm) were observed. Postoperative pain was low across techniques (VAS 0\u201310 mean: 2.67; VAS 0\u2013100 mean: 24.34). Metaregression revealed a positive association between MRC and RES (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.345) but no significant correlation between MRC and patient esthetic perception (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.091), underscoring the divergence between clinical and patient\u2010reported outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results of this systematic review and meta\u2010analysis, focusing on multiple gingival recessions, suggest that (a) CAF and TUN with the adjunctive use of autogenous graft support esthetic improvement from both professional and patient perspectives and (b) CAF and TUN with the adjunctive use of autogenous graft or graft substitutes are effective in root coverage outcomes with a minimal postoperative morbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/prd.70050","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T07:37:46Z","timestamp":1778744266000},"page":"21-41","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Esthetical and patient\u2010reported outcomes after root coverage procedures for multiple gingival recessions: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9154-637X","authenticated-orcid":false,"given":"Martina","family":"Stefanini","sequence":"first","affiliation":[{"name":"Periodontal Unit, Department of Biomedical and Neuromotor Sciences University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7663-0402","authenticated-orcid":false,"given":"Ilham","family":"Mounssif","sequence":"additional","affiliation":[{"name":"Periodontal Unit, Department of Biomedical and Neuromotor Sciences University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Figuero","sequence":"additional","affiliation":[{"name":"Etiology and Therapy of Periodontal and Peri\u2010Implant Diseases (ETEP) Research Group, Department of Dental Clinical Specialties, Faculty of Dentistry University Complutense of Madrid  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Zucchelli","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Dental School of Dental Medicine University of Bern  Bern 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