Comparative evaluation of vestibular incision subperiosteal tunnel access with platelet‑rich fibrin and connective tissue graft in the management of multiple gingival recession defects

Abstract

Background: The etiology of gingival recession is often multifactorial. Wide array of surgical techniques are available to manage gingival recession. The aim of the present study was to compare, minimally invasive approach (vestibular incision subperiosteal tunnel access [VISTA]), in combination with platelet‑rich fibrin (PRF) and connective tissue graft (CTG) in the management of multiple recession defects in maxillary anterior region. Materials and Methods: A total of 32 sites from 10 systemically healthy controls were allocated randomly to VISTA with PRF (VISTA + PRF) and VISTA with CTG (VISTA + CTG). Plaque index, gingival index, Probing probing pocket depth (PPD), relative attachment level (RAL), recession depth (RD), recession width (RW), width of keratinized gingiva (WKG), and percentage of root coverage (%RC) were calculated at 6 months postoperatively. Results: Results showed significant improvement in mean PPD, RAL, RD, RW, and KTW. %RC in VISTA + PRF and VISTA + CTG was 83.25% ± 25.02% and 86.43% ± 22.79%, respectively, at 6 months. There were no significant differences in the parameters between the VISTA + PRF and VISTA + CTG groups. Conclusion: VISTA is a minimally invasive surgical approach, which can be combined with CTG or PRF in the management of Miller’s Class I and Class II recession defects, with predictable outcomes. There were significant improvements in the clinical parameters from baseline to 6 months in both the groups. To match with the CTG, which is the gold standard procedure, PRF can be used as an alternative for treating multiple recession defects