ReviewBioengineering (Basel, Switzerland)2026
White Esthetic Score as a Tool for Esthetic Assessment of Tooth-Supported Restorations: A Comprehensive Review with Case Illustration.
Review in Bioengineering (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
backgroundThe White Esthetic Score (WES) is a standardized clinician-reported index that assesses the esthetic quality of a single-tooth restoration by comparison with a natural reference tooth, typically the contralateral tooth. It evaluates five domains: tooth form, crown outline/volume, color (hue/value), surface texture, and translucency/characterization. Each domain is scored from 0 to 2 (major discrepancy, minor discrepancy, no discrepancy), yielding a total score of 0-10; higher scores indicate a closer match. Although developed for single-tooth implant restorations, WES has also been applied to natural teeth and tooth-supported restorations.
methodsThis comprehensive review summarizes case-report evidence applying WES to tooth-supported restorations, outlining the concept, scoring method, documentation requirements, and available data on reliability and interpretation. A case illustration is also presented in which a patient received eight anterior veneers; outcomes were assessed using all WES parameters.
resultsPublished reports support WES as a practical qualitative tool to assess esthetic outcomes in tooth-supported restorations. In the presented case, the veneers achieved a WES of 9, reflecting marked improvement in tooth form, crown outline/volume, color, surface texture, and translucency/characterization.
conclusionsThe comprehensive review indicates WES is feasible for routine clinical use in practice, but agreement varies by parameter and improves with standardized photography and examiner calibration; some components show lower inter-rater agreement than simpler soft-tissue indices. Because correlations between WES and patient satisfaction are inconsistent, WES should be complemented with patient-reported outcome measures. Common thresholds consider WES ≥ 6 acceptable. Clinical use for crowns and veneers should emphasize case selection, standardized records, and combined clinician- and patient-centered outcome reporting.
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