A Novel Modified-Vista Technique With Connective Tissue Graft in the Treatment of Gingival Recession: A Case Report

The increasing esthetic demands from patients have required that clinicians sharpen their skills and adopt newer and more novel techniques to satisfy these demands. In periodontal therapy, periodontal plastic surgery poses a substantial challenge to the clinician, both because it is technique sensitive and also because it includes a wide array of procedures and their variations. Conventional plastic procedures have provided satisfactory results in the treatment of gingival recession but there is, presently, a greater need for more advanced procedures that cause less surgical morbidity as also provide improved results. Minimally invasive surgery has been harnessed in periodontics for this purpose and has been extensively used in multiple indications, including root coverage. Modified-Vestibular Incision Supra-periosteal Tunnel Access (M-VISTA) applies the principles of minimally invasive surgery to provide satisfactory results in root coverage.

A 28-year-old male patient presented with multiple Miller Class I/II buccal recession defects and associated high labial frenum on right maxillary anterior teeth. M-VISTA technique allowed coronal repositioning of gingival margin, which was then stabilized by orthodontics bracket assisted suturing technique. The V-shaped incision in the region of the frenal attachment allowed for conducting both the M-VISTA and frenectomy techniques simultaneously. Connective tissue graft was inserted in the supra-periosteal tunnel and vertical incision was sutured. Complete root coverage was achieved and maintained at 9 months with excellent esthetic outcomes.

The use of connective tissue graft along with M-VISTA technique allows the clinician to successfully treat multiple recession defects.