Vestibular incision subperiosteal tunnel access (VISTA) with platelet rich fibrin (PRF) and connective tissue graft (CTG) in the management of multiple gingival recession- A case series

Gingival recession is clinically manifested by an apical displacement of the gingival tissues, leading to root surface exposure. It is a concern for both patients and clinician for several reasons such as root hypersensitivity, erosion, root caries, and esthetics. Recently, new techniques have been suggested for the surgical treatment of multiple adjacent recession type defects. The current case series introduce a novel, minimally invasive approach applicable for both isolated recession defects as well as multiple contiguous defects in the maxillary anterior region. This case series describes the use of the vestibular incision subperiosteal tunnel access (VISTA) technique in combination with platelet-rich fibrin (PRF) membrane and VISTA with connective tissue graft (CTG) the treatment of GR defects. To the best of the authors’ knowledge, this is the first report on the use of the PRF membrane and CTG – reinforced VISTA technique for treating multiple gingival recession defects. Case Series: Four patients with multiple GRs were selected for this case series. The VISTA technique allowed coronal repositioning of the gingival margin, which was then stabilized by the coronally anchored suturing technique. PRF membrane was inserted inside the subperiosteal tunnel for group I and CTG for group II, and the vertical incision was sutured. Patients were kept under observation for 6 months. Conclusion: This use of PRF membrane and CTG along with the VISTA technique allows clinicians to successfully treat multiple GR defects.