Vestibular Incision Subperiosteal Tunneling Approach (VISTA) with Platelet-Rich Fibrin (PRF) vs VISTA Alone in Multiple Recession Treatment: A Split-Mouth Randomized Clinical Trial

Вестибулярный разрез с субпериостальным туннелированием (VISTA) с тромбоцитарно‑богатой фибриновой матрицей (PRF) против только VISTA в лечении множественных рецессий: рандомизированное клиническое исследование с зеркальным дизайном
Yousef Khader, Louai Al Kababji, Rola Alhabashneh, Reem S. Abdelhafez, H. Nasrallah
2023-08-08

KTWMiller Class I/IIPRFPlatelet-Rich FibrinVASVISTAVestibular Incision Subperiosteal Tunneling Approachgingival phenotypegingival thicknesskeratinized tissue widthlow postoperative painmaxillary recessionsmultiple gingival recessionpatient-centered outcomessplit-mouth randomized clinical trialvisual analogue scale
BACKGROUND: Gingival recession treatment is one of the major clinical challenges in periodontics, various surgical techniques were proposed to correct it. Most of these techniques are suitable for isolated recession sites and involve the harvesting of autogenous tissue graft; which increase patient morbidity and might result in inferior esthetics due to incision design. This study assessed the benefit of adding Platelets Rich Fibrin (PRF) to Vestibular Incision Subperiosteal Tunneling Approach (VISTA) in treating multiple gingival recession compared to using VISTA alone. Forty-one teeth with Miller Class I/II were randomized in a split mouth design. Multiple clinical parameters were tested including the change in gingival thickness over time, keratinized tissue width KTW and the gingival phenotype using the transparency of periodontal probe. Patient-centered outcomes were also assessed via Visual Analogue Scale VAS. CONCLUSION: Multiple Miller Class 1 and Class 2 recessions in the maxilla can be effectively treated with VISTA. However, when used in conjunction with PRF no significant differences were detected in any parameter. VISTA has been shown to be associated with a low level of pain for patients following surgery and can be used for patients with high esthetic demand.
1
Adding platelet-rich fibrin (PRF) to VISTA produced no significant differences in any measured clinical parameter.
2
Clinical parameters assessed included gingival thickness change over time, keratinized tissue width (KTW), and gingival phenotype by probe transparency.
3
Patient-centered outcomes (pain) measured by Visual Analogue Scale showed VISTA is associated with low postoperative pain.
4
VISTA effectively treats multiple Miller Class I and II maxillary gingival recessions.
5
VISTA is suitable for patients with high aesthetic demands and avoids autogenous tissue graft harvesting morbidity.

Vestibular Incision Subperiosteal Tunneling Approach (VISTA) procedure for treating multiple gingival recessions (with or without Platelet-Rich Fibrin)

Clinical effectiveness and patient-centered outcomes (gingival thickness change, keratinized tissue width, gingival phenotype, and postoperative pain) of VISTA with PRF versus VISTA alone in treating multiple Miller Class I/II gingival recessions

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2023-08-08
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Yousef Khader
Louai Al Kababji
Rola Alhabashneh
Reem S. Abdelhafez
H. Nasrallah
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