Comparative study of the modified VISTA technique (m-VISTA) versus the coronally advanced flap (CAF) in the treatment of multiple Miller class III/RT2 recessions: a randomized clinical trial

• Published in: Clinical oral investigations Vol. 27; no. 2; pp. 505 - 517
• Main Authors: Fernández-Jiménez, Aitziber, Estefanía-Fresco, Ruth, García-De-La-Fuente, Ana María, Marichalar-Mendia, Xabier, Aguirre-Urizar, José Manuel, Aguirre-Zorzano, Luis Antonio
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2023; Springer Nature B.V
• Subjects: Clinical trials; Connective tissue; Connective Tissue - transplantation; Connective tissues; Dentistry; Gingiva - transplantation; Gingival Recession - surgery; Humans; Medicine; Molars; Nursing; Original; Original Article; Plastic surgery; Premolars; Skin & tissue grafts; Statistical analysis; Surgical Flaps - surgery; Surgical techniques; Sutures; Tooth Root - surgery; Treatment Outcome; Connective tissue; Plastic surgery; Clinical trial; Gingival Recessions
• ISSN: 1436-3771; 1432-6981; 1436-3771
• DOI: 10.1007/s00784-022-04746-w

Objectives To compare the percentage of mean root coverage (MRC%) obtained in the treatment of multiple Miller class III/RT2 gingival recessions using the modified VISTA (m-VISTA) technique versus the coronally advanced flap (CAF) technique, using a connective tissue graft (CTG) in both cases. Materials and methods Twenty-four patients were randomly treated with m-VISTA (test group (TG) = 12) or CAF (control group (CG) = 12). A calibrated, experienced, and blinded examiner collected data related to multiple periodontal clinical variables, especially the recession (REC) in order to calculate the MRC% at 6 and 12 months, which was the primary outcome of the study. Also, the radiological bone level, the characteristics of the CTG, and postsurgical incidences were assessed. Finally, a descriptive and an analytical statistical analysis of the variables and their associations was performed. Results The recessions ( n  = 84) were located mainly in the mandible ( n  = 65) and in posterior sectors (premolars: n  = 35; molars: n  = 8). At 6 months, the MRC% was 61% (2 mm) for both study groups, and at 12 months, it increased to 73.26% (2.11 mm) in the TG and decreased to 56.49% (1.78 mm) in the CG. Conclusion When approaching multiple Miller class III/RT2 recessions, there were no statistically significant differences in the MRC% at 6 and 12 months between the group treated with the m-VISTA technique and the group treated with the CAF. Clinical relevance The characteristics of the m-VISTA technique, such as the closed approach, the mobilization of the papilla, and the coronal stabilization of the CTG, could facilitate the maturation of the tissues in the treatment of Miller class III/RT2 recessions. This would favor better root coverage. Trial registration NCT03258996.