Internal Frenectomy-Vestibular Incision Subperiosteal Tunnel Access (IF-VISTA). A technical report

The treatment of gingival recession (GR) unequivocally encompasses the proper identification and management of all etiologic and contributory factors. The presence of high frenulum attachment and short vestibule depth is frequently related to the initiation and progression of GR defects, particularly in the anterior mandible. This technical report presents a bilaminar grafting technique that involves the utilization of a Vestibular Incision Subperiosteal Tunnel Access (VISTA) approach in combination with an internal frenectomy to excise the inner components of the frenulum and muscle insertions. This surgical protocol allows the coronal repositioning of the gingival margin while eliminating the insertion and potential for recurrence of the frenulum attachment and muscle pull. The results of the presented case illustration demonstrate excellent root coverage, including coronal migration of the interproximal papillae. Additionally, the coverage obtained remained stable after 12 months of follow-up.