Incision Subperiosteal Tunnel Access Technique Research Articles

Novel biomaterial advanced platelet rich fibrin plus block for multiple gingival recession.

The study was aimed to assess and compare hard and soft tissue augmentation clinicoradiographically with and without advanced platelet rich fibrin + (A-PRF+) block for the treatment of multiple gingival recession using vestibular incision subperiosteal tunnel access (VISTA). A total of 24 patients, exhibiting multiple Miller's Class I or II recession in maxillary esthetic zone were included. Participants were divided into 2 groups, Group 1 treated with VISTA & A-PRF+ block whereas Group 2 with VISTA technique alone. Clinical parameters Probing Depth (PD), Width of Keratinized Gingiva (WKG), Gingival Biotype (GB), Recession Depth (RD) and Clinical Attachment Level (CAL) were recorded at baseline and at the end of 6 months. The radiographic CBCT measurements of labial plate thickness was taken at baseline and 6 months postoperatively. From baseline to 6 months both the groups showed a clinical and statistical improvement in the parameters. However, a statistically significant difference between both the treatment modalities was not observed. In the inter group comparison radiographically, labial plate thickness was statistically significant at the end of 6 months when compared to the baseline. A-PRF+ block along with VISTA technique can be an alternative effective root coverage procedure for the management of multiple gingival recession in the maxillary esthetic zone. This article is protected by copyright. All rights reserved.

Comparison between Buccal Fat Pad Versus Platelet Rich Fibrin Using Vestibular Incision Subperiosteal Tunnel Access Technique in the Treatment of Gingival Recession Class II

Comparison between Buccal Fat Pad Versus Platelet Rich Fibrin Using Vestibular Incision Subperiosteal Tunnel Access Technique in the Treatment of Gingival Recession Class II

Minimally invasive treatment of gingival recession by vestibular incision subperiosteal tunnel access technique with collagen membrane and advanced platelet-rich fibrin: A 6-month comparative clinical study.

Aim:The study aimed to assess the minimally invasive Vestibular Incision Subperiosteal Tunnel Access (VISTA) technique for treatment of Millers Class I or Class II buccal gingival recession defects and to compare the effectiveness of a bioresorbable collagen membrane or advanced platelet rich fibrin (A-PRF).Methods and Material:20 sites with Millers Class I or II gingival recession were recruited and allocated into 2 groups with 10 sites each. Group 1: VISTA with A-PRF, Group 2: VISTA with with bioresorbable collagen membrane (Healiguide)®.Standardized Clinical Parameters:Plaque Index (PI), Gingival Index (GI), Clinical attachment level (CAL )Pocket Probing Depth (PPD) Recession Height (RH ) and width of keratinized gingiva (WKG) were measured at baseline 3 months and 6 months.Results:Both groups showed significant improvement in clinical parameters. However reduction in recession height and mean root coverage percentage was greater in A-PRF group after 6 months.Conclusions:VISTA with both A-PRF and Healiguide showed good clinical outcomes but better results were obtained when A-PRF was used.

Patient-centered comparative outcome analysis of platelet-rich fibrin-reinforced vestibular incision subperiosteal tunnel access technique and Zucchelli's technique.

Background:Multiple gingival recession (MGR) coverage, especially in esthetic area, demands a high patient satisfaction. Coronally advanced flap modifications, namely Zucchelli's technique (ZT) and vestibular incision subperiosteal tunnel access (VISTA), are techniques, recommended in the correction of MGR.Aim:The purpose was to comparatively analyze the ZT and VISTA technique reinforced with the platelet-rich fibrin membrane in the management of MGR.Materials and Methods:This split-mouth, randomized study comprised 16 consenting, systemically healthy participants. The bilateral Miller's multiple class I and II lesions were managed with ZT and VISTA technique and had a follow-up period of 18 months. Gingival thickness (GT), mean percentage of root coverage, and patient-centered outcome scales, including patient comfort score, patient esthetic score, and hypersensitivity score, were the primary outcome measures. Further clinical parameters assessed were gingival index, probing depth, clinical attachment level, and width of keratinized gingiva.Statistical Analysis and Results:Paired t-test and unpaired t-test were used for intragroup comparison and intergroup analysis, respectively. While both the techniques exhibited high root coverage percentage (VISTA: 93.95% and ZT: 96.84%), statistically significant difference was noted with patient esthetic score and surgical mortality score in VISTA.Conclusion:Both ZT and VISTA were effective in terms of root coverage and GT augmentation in MGR management. From the patient's perspective, they preferred VISTA technique over ZT, stating its minimal postoperative morbidity and improved esthetic outcome. Hence, within the limitations of this study, the VISTA technique was found to be a superior alternative compared to that of ZT in MGR management.

Vestibular Incision Subperiosteal Tunnel Access Technique with Platelet-Rich Fibrin Compared to Subepithelial Connective Tissue Graft for the Treatment of Multiple Gingival Recessions: A Randomized Controlled Clinical Trial.

Background:The aim of this study was to compare the effectiveness of root coverage through vestibular incision subperiosteal tunnel access (VISTA) technique using platelet rich fibrin (PRF) or subepithelial connective tissue graft (SCTG) in multiple gingival recessions.Materials and Methods:A total of 20 patients with multiple gingival recessions were included, and 10 subjects were randomly allocated to test group (VISTA with PRF) and 10 patients to control group (VISTA with SCTG). Clinical parameters were recorded at baseline, 3 months, and 6 months. Patient's response toward the treatment was also assessed by questionnaire.Results:All the clinical parameters in the study have showed better results in test group when compared to control group after a follow up period of 6 months with statistical significance.Conclusion:The results of the present study suggested that multiple gingival recessions can be successfully treated with both procedures, but better root coverage and a greater increase in keratinized tissue were achieved with the VISTA technique with SCTG. All the patients in both groups felt it was worth undergoing the treatment.

Use of Vestibular Incision Subperiosteal Tunnel Access Technique with Platelet Rich Fibrin in the Treatment of Miller Class I Gingival Recession: A Case Report

Gingival recession is defined as apical migration of gingival margins resulting in exposure of the root surface. It can be either localized or generalized, involving one or more than 1 surfaces and there by leading to functional & esthetic problems like hypersensitivity, cervical abrasions & root caries. Various techniques have been developed to achieve root coverage. The current case report describes treatment of multiple class I gingival recession using vestibular incision sub periosteal tunnel access (VISTA) technique and platelet rich fibrin (PRF) membrane. Position of gingiva was maintained using coronally anchored sutures during initial healing period. The use of PRF membrane along with the VISTA allows clinicians to successfully treat multiple gingival recession defects.

Minimally Invasive Treatment of Mandibular Anterior Lingual Defects by Vestibular Incision Subperiosteal Tunnel Access Technique and Connective Tissue Graft: A Case Report

Introduction: Treatment of recession defects on the lingual surface of mandibular anterior teeth is challenging owing to site‐specific anatomic features of this region. Surgical approaches based on use of subepithelial connective tissue grafts (SCTGs) are considered the “gold standard” for treatment of multiple recession defects. To the best of the authors’ knowledge, this is believed to be the first case report of an attempt to correct lingual recession by SCTG with the minimally invasive vestibular incision subperiosteal tunnel access technique.Case Presentation: A non‐smoking 55‐year‐old male patient presented with hypersensitivity in his mandibular anterior teeth in August 2016. Multiple lingual recession defects were treated by placing a SCTG harvested from the palate underneath the subperiosteal tunnel using a midline access incision. Six months after treatment, a significant increase of root coverage (88.17%), gain in gingival thickness (1.29 mm), and width of keratinized gingiva (1.41 mm) led to a promising outcome and high patient satisfaction.Conclusion: A minimally invasive surgical technique has been presented that can restore the functional properties of lingual gingiva of the mandibular anterior teeth by repairing gingival defects and reestablishing integrity of the zone of keratinized gingiva.

Platelet-rich fibrin-reinforced periosteal pedicle graft with vestibular incision subperiosteal tunnel access technique for the coverage of exposed root surface

Platelet-rich fibrin (PRF) has been shown to promote soft tissue healing because it contains growth factors. Periosteal pedicle graft (PPG) provides not only good and predictable root coverage, but also reduces the need for the second surgical site. Access to the surgical site is obtained by minimally invasive technique known as vestibular incision subperiosteal tunnel access (VISTA) technique. Therefore, the purpose of this case report was to evaluate the PRF-reinforced PPG with VISTA technique for the coverage of exposed root surface. A patient with Miller Class II gingival recession of 6.5 mm was treated by PRF-reinforced PPG with VISTA technique. PRF was prepared from whole blood and applied to the root surface. After 6 months, 5.5 mm, that is, 84.6% of the root coverage was obtained. PRF-reinforced PPG with VISTA technique can be predictably used for the achievement of successful root coverage. The long-term follow-up with histologic studies will be required to obtained more information about PRF-reinforced PPG with VISTA technique for the coverage of exposed root surface. Clinical Relevance to Interdisciplinary Dentistry PRF is a fibrin matrix network in which platelets are trapped. Platelets in PRF release high amount of growth factors which take part in soft tissue and hard tissue repair and regeneration. As PRF-reinforced PPG and VISTA technique for coverage of exposed root surface showing good promising results, PRF can be used in various aspects/disciplines of the dentistry as well as in interdisciplinary dentistry to reinforced natural tissue regeneration (NTR) and natural bone regeneration (NBR).

Platelet‐Rich Fibrin–Reinforced Vestibular Incision Subperiosteal Tunnel Access Technique for Recession Coverage

Introduction: Gingival recession (GR) presents with breakdown of both soft and hard tissues and can cause major functional and esthetic problems. Treatment of GR, especially multiple recession defects, presents a challenge because several recession defects must be treated at a single surgical session to minimize patient discomfort. New materials and techniques are currently being developed to obtain predictable root coverage. This case series describes the use of the vestibular incision subperiosteal tunnel access (VISTA) technique in combination with platelet‐rich fibrin (PRF) membrane in the treatment of GR defects. To the best of the authors’ knowledge, this is the first report on the use of the PRF membrane–reinforced VISTA technique.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, and the vertical incision was sutured. Patients were kept under observation for 6 months.Conclusion: This use of PRF membrane along with the VISTA technique allows clinicians to successfully treat multiple GR defects.