Gingival recession can be assessed using digital intraoral scans combined with software-based analysis. By capturing a digital representation of the teeth and surrounding soft tissues, clinicians can visualize gingival margins, evaluate recession, and monitor changes over time within a digital workflow.
Gingival recession is traditionally diagnosed through visual inspection and clinical measurements. Today, digital technologies provide another way to assess gingival conditions by capturing detailed digital records of the teeth and surrounding soft tissues.
Using an intraoral scan, clinicians can visualize gingival margins and other anatomical features relevant to recession assessment. When combined with software-based analysis, these digital records can support the evaluation and classification of gingival recession within a structured digital workflow.
For gingival recession assessment, an intraoral scan captures a digital representation of the teeth, gingival margins, and surrounding soft tissues. This allows clinicians to visualize the relationship between the tooth surface and the position of the gingival tissue in a digital environment.
The scan records anatomical features that are relevant to recession assessment, including gingival margin position, exposed root surfaces, recession depth, and soft tissue contours. These structures can then be viewed as a 3D model and examined from different angles.
The scan itself does not diagnose gingival recession. Instead, it provides the digital information that can be reviewed, measured, and analyzed within software designed to support gingival recession assessment.
For a detailed explanation of how intraoral scanning captures and processes digital data, see our guide on how intraoral scanners work.
Taking an intraoral scan has traditionally been used as a technology to replace the somewhat cumbersome process of conventional impression taking. Taking a full arch scan can be done in under a minute, depending on the experience of the operator. An average clinician would spend anywhere between 1 and 3 minutes to capture all data.
Software-based diagnosis begins with a digital intraoral scan of the teeth and surrounding soft tissues. The captured scan data is processed and displayed as a digital model that can be reviewed within a software environment.
The workflow follows a structured sequence: capture of the relevant anatomical structures, processing of scan data, creation of a visual 3D model, and presentation of information that supports clinical assessment. Together, these steps provide a digital representation of the patient's oral condition that can be reviewed alongside other clinical findings.
The following sections explain each stage of this process, from scan capture through to software-assisted analysis.
The process begins with capturing a digital record of the teeth and surrounding soft tissues. For gingival recession assessment, the scan captures information related to the position of the gingival margin, recession depth, and tissue contours.
This digital record provides the information that is used in the subsequent stages of visualization and software-based analysis.
Once the scan has been captured, the data is processed to create a digital 3D representation of the scanned area. The captured information is organized and displayed within the software environment, allowing the clinician to view the scanned teeth and surrounding soft tissues as a digital model.
This processed digital model forms the basis for subsequent visualization and analysis.
After processing, the scan data is displayed as a 3D color model of the scanned area. This visual representation allows the clinician to view the teeth and surrounding soft tissues within a digital environment.
The model can be examined from different angles and used to review anatomical structures relevant to gingival recession assessment, including the gingival margin and surrounding tissue contours.
Once the scan has been processed and displayed as a 3D color model, the software can analyze the captured scan data and present findings for clinician review. In the case of gingival recession, the software highlights and visualizes areas that may require further clinical examination.
The analysis is displayed within the software environment and is intended to support the clinician's assessment of the scanned area. The software provides an additional source of visual information for the clinician to review, but the final diagnosis must always be made by the dentist.
The results can be reviewed as part of the overall clinical assessment and stored as part of the patient's digital record.
This scan-based workflow sits within 3Shape Dx software, which supports AI-assisted assessment of scan data and helps clinicians review areas that may require further clinical examination.
The workflow begins with an intraoral scan of the teeth and surrounding soft tissues. The scan data is processed to create a 3D color model that can be reviewed within the software environment.
The software can then perform AI-assisted analysis of the scan data and display findings that may require further clinical examination. These findings support the clinician's assessment by highlighting areas that may require further examination, while the final diagnosis remains the responsibility of the dentist.
The results can be reviewed over time, incorporated into clinical records, and used as part of patient communication and treatment planning.
For a demonstration of how AI-assisted analysis is generated and reviewed within the software, watch the TRIOS Dx workflow video.
Classification systems are used to describe the severity and characteristics of gingival recession. They provide a structured way to assess recession and support clinical evaluation, communication, and treatment planning.
Some classification systems for gingival recession have been proposed the Cairo classification1 and the Miller classification2.
Each uses different criteria to describe the extent of recession and its clinical implications.
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Both systems can be used to classify gingival recession, but they assess it differently.
The Cairo classification focuses primarily on the level of interdental soft tissue loss, making it relatively straightforward to apply during clinical examination.
The Miller classification requires assessment of the mucogingival junction, interdental bone levels, and tooth position, which can introduce greater variability between clinicians.
Dx identifies gingival recession based on exposed root surfaces and provides recession depth measurements.
For each recession site, the software displays central and maximum recession depth measurements. Findings are grouped into categories based on maximum recession depth, including greater than 0.25 mm, 0.5 mm, 3 mm, and 5 mm.
Clinicians can use these measurements to support their interpretation and apply the appropriate clinical classification.
The Cairo classification was adopted as part of the 2017 World Workshop on Periodontal Classification. It is more commonly used than Miller in contemporary research and clinical practice.1
The Miller classification is still widely recognized and is often referenced when discussing older literature or communicating with clinicians who have trained using the original system.2
Classifications help clinicians estimate how predictable root coverage treatment is likely to be.
RT1 and Miller Class I/II generally have a favorable prognosis, and full root coverage may be achievable. RT2 and Miller Class III typically allow only partial root coverage, requiring more careful management of patient expectations.
RT3 and Miller Class IV are generally considered unsuitable for root coverage procedures, shifting treatment towards maintenance, management of causative factors, and alternative solutions.
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Gingival recession is traditionally assessed through visual inspection and clinical measurements, including use of a periodontal probe. Digital analysis offers another way to review gingival recession by using scan data and software-based visualization.
Several factors can affect the assessment of gingival recession. The biggest source of error is identifying the cemento-enamel junction (CEJ).
Calculus, restorations, erosion, and abrasion can obscure the CEJ, meaning clinicians may be estimating rather than measuring it directly. Inflammation can also affect assessment by causing tissue swelling. Other factors include tissue phenotype, especially thin biotypes, as well as tooth position, rotations, buccal displacement, and root prominences.
A 3Shape sponsored cross-sectional study compared on-scan assessment of gingival recession with clinical assessment using a periodontal probe. The study evaluated the diagnostic accuracy, precision, and measurement agreement between the two methods.
The findings showed that on-scan measurements were reproducible and demonstrated measurement agreement with clinical assessment.
The study also noted that clinical measurement with a periodontal probe remains the current reference standard, while intraoral scans may help address some of the limitations of clinical assessment.3
For more information, see this study.
Deep dive
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Gingival recession is traditionally diagnosed through visual inspection and clinical measurements, including assessment of the gingival margin and measurement of recession using a periodontal probe.
These findings are used to evaluate the extent and severity of recession.
Digital workflows provide an additional method of assessment by using intraoral scans and software-based analysis to visualize and review gingival recession within a digital environment.
Regardless of the method used, the final diagnosis remains the responsibility of the clinician.
No. Digital analysis can support the assessment of gingival recession by providing visualization and software-assisted review of scan data, but it does not replace clinical examination.
A periodontal probe remains an important tool for clinical assessment and is commonly used as the reference standard for measuring gingival recession.
Digital analysis can provide additional information, but the final diagnosis must always be made by the clinician.
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Clinical implications extend beyond identifying areas that may require further examination. The visualization, measurement, and documentation capabilities of the software can support routine checkups, patient communication, and day-to-day clinical workflows.
During a routine dental checkup, clinicians can review visualizations and measurements for findings such as gingival recession, plaque accumulation, tooth wear, and surface caries alongside their standard assessment.
Dx software highlights areas that may require closer examination and allows clinicians to compare scans from different visits to monitor changes over time. The software supports the assessment process, while diagnosis and treatment decisions remain the responsibility of the clinician.
Patients may find it easier to understand findings when they can see them displayed directly on a scan. Dx Plus provides color-coded visualizations and measurements that can help make conditions such as gingival recession easier to explain during the consultation.
By showing findings rather than describing them verbally, clinicians can help patients better understand what they are seeing, why it matters, and the reasoning behind recommended monitoring or treatment. Selected findings can also be shared through the DentalHealth app for review after the appointment.
Dx Plus can support clinical workflows by bringing visualizations, measurements, and documented findings together in one place. Findings can be summarized in a report and stored with the patient's scan data, providing a visual reference that clinicians can use during documentation and follow-up.
In practices where trained team members perform scans, the scan and analysis may be available before the dentist begins the consultation. This allows clinicians to focus on assessment, treatment planning, and patient communication while retaining responsibility for assessment and treatment decisions.
Digital analysis of gingival recession combines intraoral scan data with software-based visualization and measurement to support clinical assessment.