Impact of surgeon experience level on outcomes of three different root coverage procedures for RT1 gingival recession

Wentao Sun; Jiachen Dong; Mengjun Sun; Yue Liao; Zhongchen Song

doi:10.1186/s40902-026-00514-y

Impact of surgeon experience level on outcomes of three different root coverage procedures for RT1 gingival recession

Maxillofac Plast Reconstr Surg. 2026 May 29;48(1):16. doi: 10.1186/s40902-026-00514-y.

Authors

Wentao Sun¹, Jiachen Dong¹, Mengjun Sun¹, Yue Liao¹, Zhongchen Song²

Affiliations

¹ Department of periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China.
² Department of periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China. szhongchen@sina.com.

Abstract

Background: Gingival recession (GR) is a common dental condition. Root coverage procedures (RCPs) aim to restore the gingival margin to its original position and maximize root surface coverage. The impact of surgeon experience on surgical outcomes has not been systematically evaluated. This retrospective study aimed to investigate the impact of surgeon experience level on the outcomes of 3 different RCPs for RT1 GR by comprehensively assessing clinical and esthetic parameters before and after surgery.

Results: A total of 304 patients (1,020 teeth) were included in this study. Surgeons with more than 5 years of experience achieved a significantly higher percentage of root coverage (PRC) (96.34 ± 10.95%) and significantly lower clinical attachment level (CAL) values (1.20 ± 0.42 mm) than less experienced surgeons (p < 0.05). Notably, surgical duration decreased markedly with increasing surgical experience (p < 0.0001). The root coverage esthetic score (RES) did not differ significantly among the three groups. Group A demonstrated higher mucosal scar index (MSI) values for the coronally advanced flap combined with connective tissue graft (CAF + CTG).

Conclusion: Surgeon experience level is associated with clinical efficacy and surgical efficiency in RCPs, with more experienced surgeons achieving superior PRC and attachment gain. Esthetic outcomes were comparable across experience levels. Additionally, more experienced surgeons had shorter operative times.

Keywords: Coronally advanced flap; Envelope coronally advanced flap; Gingival recession; Root coverage procedures; Surgeon’s experience level; Vestibular incision subperiosteal tunnel access.

Abstract

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