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

Subbareddy, Bukkapatnam; Penmetsa, Gautami S; Dwarakanath, C D; Devi, Panda Kausalya; Bhavana, Parimisetti; Radharani, K

doi:10.4103/ccd.ccd_405_19

Cited by 13 publications

(24 citation statements)

References 19 publications

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“…The large avascular area, which usually leads to difficulty in restoring blood supply to the grafted tissue and which is vital for healing, the need for large amount of donor tissue, and the presence of non-carious cervical lesions, which are often associated with multiple gingival recessions, compound the problem[ 3 ]. Also, muscle pull during healing often leads to incomplete root coverage or relapse of the recession[ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Also, muscle pull during healing often leads to incomplete root coverage or relapse of the recession[ 4 ]. Taking all these factors into consideration, the VISTA technique, which is minimally invasive, does not compromise the blood supply, and yet results in improvement of all the clinical parameters, can be considered an accepted approach[ 3 , 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…While inflammation is the main etiologic factor for gingival recession, other anatomical factors, like thin biotype, abnormal tooth position (positioned too far buccally or lingually, direct trauma associated with malocclusion, aberrant frenal attachment, class-II division 2 malocclusion), and iatrogenic factors, like mechanical trauma (impaction of foreign bodies, faulty tooth brushing, poorly designed partial dentures) can also cause gingival recession. Subgingival restoration margins, the presence of calculus, periodontal disease, and smoking also plays role in the etiology of gingival recession[ 1 - 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…The 6-mo follow up results showed a statistically significant difference in favor of the VISTA + ADM technique than the TUN + ADM technique. This minimally invasive procedure promises adequate blood supply to the surgical site as it requires a small opening leading to the undermining of the periosteum, completely free from the area of root coverage, which further enhances the coronal positioning of the flap passively onto the exposed root surface[ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Along with various techniques for root coverage procedure, several grafts, such as CTG, ADM allograft, Amniotic membrane, and bioactive glass, can be advocated for root coverage[ 3 ]. Adjunctive agents, like recombinant human growth factor, platelet rich plasma (PRP), and platelet-rich fibrin (PRF) have been used to accelerate healing and enhance clinical outcomes[ 3 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Comparative evaluation of effect of injectable platelet-rich fibrin with collagen membrane compared with collagen membrane alone for gingival recession coverage

Patra¹,

Raj²,

Katti³

et al. 2022

WJEM

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BACKGROUND Collagen membrane and platelet-rich fibrin (PRF) have emerged as vital biomaterials in the field of periodontal regeneration. Minimally invasive techniques are being preferred by most periodontists, as it is patient compliant with fewer post-surgical complications as compared to conventional surgical techniques. Thus, in this study we have evaluated the effect of injectable PRF (i-PRF) with collagen membrane compared with collagen membrane alone using vestibular incision subperiosteal tunnel access (VISTA) technique for gingival recession coverage. AIM To compare the efficacy of VISTA using collagen membrane with collagen membrane soaked in injectable PRF for gingival recession coverage. METHODS A split mouth randomized controlled clinical trial was designed;13 subjects having at least 2 teeth indicated for recession coverage were enrolled in this study. The sites were randomly assigned to control group (VISTA using collagen membrane alone) and the test group (VISTA using collagen membrane with i-PRF). The clinical parameters assessed were pocket depth, recession depth (RD), recession width (RW), relative attachment level, keratinised tissue width (KTW), keratinised tissue thickness (KTT), and percentage root coverage. RESULTS RD showed a statistically significant difference between the test group at 3 mo (0.5 ± 0.513) and 6 mo (0.9 ± 0.641) and the control group at 3 mo (0.95 ± 0.51) and 6 mo (1.5 ± 0.571), with P values of 0.008 and 0.04, respectively. RW also showed a statistically significant difference between the test group at 3 mo (1 ± 1.026) and 6 mo (1.65 ± 1.04) and the control group at 3 mo (1.85 ± 0.875) and 6 mo (2.25 ± 0.759), with P values of 0.008 and 0.001, respectively. Results for KTW showed statistically significant results between the test group at 1 mo (2.85 ± 0.489), 3 mo (3.5 ± 0.513), and 6 mo (3.4 ± 0.598) and the control group at 1 mo (2.45 ± 0.605), 3 mo (2.9 ± 0.447), and 6 mo (2.75 ± 0.444), with P values of 0.04, 0.004, and 0.003, respectively. Results for KTT also showed statistically significant results between test group at 1 mo (2.69 ± 0.233), 3 mo (2.53 ± 0.212), and 6 mo (2.46 ± 0.252) and the control group at 1 mo (2.12 ± 0.193), 3 mo (2.02 ± 0.18), and 6 mo (1.91 ± 0.166), with P values of 0.001, 0.001, and 0.001, respectively. The test group showed 91.6%, 81.6%, and 67% root coverage at 1 mo, 3 mo, and 6 mo, while the control group showed 82.3%, 66.4%, and 53.95% of root coverage at 1 mo, 3 mo, and 6 mo, respectively. CONCLUSION The use of minimally invasive VISTA technique along with collagen membrane and injectable form of platelet-rich fibrin can be successfully used as a treatment method for multiple or isolated gingival recessions of Miller’s class-I and class-II defects.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparative evaluation of effect of injectable platelet-rich fibrin with collagen membrane compared with collagen membrane alone for gingival recession coverage

Patra¹,

Raj²,

Katti³

et al. 2022

WJEM

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Efficacy of biologics in root coverage and gingival augmentation therapy: An American Academy of Periodontology best evidence systematic review and network meta‐analysis

Barootchi

Ávila‐Ortiz

2022

Journal of Periodontology

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Background: The aim of this systematic review was to assess the efficacy of three biologics, namely autologous blood-derived products (ABPs), enamel matrix derivatives (EMD) and recombinant human platelet-derived growth factor BB (rhPDGF-BB), in root coverage and gingival augmentation therapy. Methods: The protocol of this PRISMA 2020-compliant systematic review was registered in PROSPERO (CRD42021285917). After study selection, data of interest were extracted. A network meta-analysis (NMA) was conducted to assess the effect of different surgical interventions on the main clinical outcomes of interest (i.e., mean root coverage [MRC%], complete root coverage [CRC%], keratinized tissue width [KTW], gingival thickness [GT] change, and recession depth [RD] reduction).Results: A total of 48 trials reported in 55 articles were selected. All studies reported on the treatment of gingival recession defects for root coverage purposes. Forty-six treatment arms from 24 trials were included in the NMA. These arms consisted of treatment with coronally advanced flap (CAF) alone, EMD + CAF, platelet-rich fibrin (PRF) + CAF, and subepithelial connective tissue graft (SCTG) + CAF. Regarding MRC%, SCTG+CAF was associated with a significant higher estimate (13.41%, 95% CI [8.06-18.75], P < 0.01), while EMD+CAF (6.68%, 95% CI [−0.03 to 13.4], P = 0.061) and PRF+CAF (1.03%, 95% CI [−5.65 to 7.72], P = 0.71) failed to show statistically significant differences compared with CAF alone (control group) or with each other. Similarly, only SCTG+CAF led to a significantly higher CRC% (14.41%, 95% CI [4.21 to 24.61], P < 0.01), while treatment arms EMD + CAF (13.48%, 95% CI [−3.34 to 30.32], P = 0.11) and PRF+CAF (-0.91%, 95% CI [−15.38, 13.57], p = 0.81) did not show significant differences compared with CAF alone or with each other. Differences in the CI of PRF+CAF (symmetrical around a zero adjunctive effect) and EMD+CAF (nonsymmetrical) suggest that EMD could have some additional value compared with PRF. Treatment with SCTG+CAF led to a statistically significant higher RD reduction (-0.39 mm, 95% CI [−0.55 to 0.22], P < 0.01), however EMD+CAF

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Clinical efficacy of Vestibular Incision Subperiosteal Tunnel Access (VISTA) for treatment of multiple gingival recession defects: a systematic review, meta-analysis and meta-regression

Sabri,

SamavatiJame,

Sarkarat

et al. 2023

Clin Oral Invest

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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

Cited by 13 publications

References 19 publications

Comparative evaluation of effect of injectable platelet-rich fibrin with collagen membrane compared with collagen membrane alone for gingival recession coverage

Comparative evaluation of effect of injectable platelet-rich fibrin with collagen membrane compared with collagen membrane alone for gingival recession coverage

Efficacy of biologics in root coverage and gingival augmentation therapy: An American Academy of Periodontology best evidence systematic review and network meta‐analysis

Clinical efficacy of Vestibular Incision Subperiosteal Tunnel Access (VISTA) for treatment of multiple gingival recession defects: a systematic review, meta-analysis and meta-regression

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