Double-VISTA technique with connective tissue graft or acellular dermal matrix for treating multiple recessions...

This retrospective study evaluated whether clinical outcomes differed between connective tissue graft (CTG) and allogeneic solvent-dehydrated acellular dermal matrix (ADM) for treating multiple gingival recessions associated with non-carious cervical lesions (NCCLs) using partial restoration and the double-vestibular incision subperiosteal tunnel access (double-VISTA) technique. Factors associated with complete recession coverage (CRC) were also analyzed.

Electronic health records from an academic institution were reviewed. Cases included three or more adjacent teeth with RT1 or RT2 recessions treated with CTG or ADM using the double-VISTA technique and ≥12 months of follow-up. The primary outcome was CRC. Secondary outcomes included recession depth (RD) reduction, percentage of RD reduction, keratinized tissue width (KTW) gain, Class I buccal furcation coverage, and Modified Root Coverage Esthetic Score (MRCES). Multivariate generalized estimating equations identified predictors of CRC.

A total of 226 teeth from 36 patients met inclusion criteria. CRC was significantly higher with CTG than ADM (80.0% vs. 48.8%, p < 0.001). CTG demonstrated greater RD reduction (2.57 ± 1.01 mm vs. 2.33 ± 0.77 mm, p = 0.019), percentage of RD reduction (89.9% vs. 80.6%, p < 0.001), KTW gain (0.39 ± 0.54 mm vs. 0.14 ± 0.35 mm, p < 0.001), and MRCES. Class I buccal furcation coverage was more frequent with CTG than ADM (53.8% vs. 9.1%, p = 0.028). RT1 defects, absence of Class I furcation involvement, thick gingival phenotype, and CTG as grafting material, were associated with CRC.

CTG provided more favorable CRC, RD reduction, KTW gain, MRCES, and Class I furcation coverage compared with ADM. CRC was strongly associated with baseline recession type, furcation involvement status, gingival phenotype, and grafting material used.

This study looked at two commonly used soft tissue grafting materials for treating gum recession affecting multiple teeth, especially when teeth also had surface structure loss not caused by decay. The two materials compared were connective tissue graft (taken from the patient's hard palate) and a donated human-derived tissue product. Both were used together with a surgical method called the double-vestibular incision subperiosteal tunnel access (double-VISTA) technique. Researchers reviewed dental records from a university clinic and analyzed outcomes from 226 teeth in 36 patients who were followed for at least 1 year. The main goal was to evaluate how often complete root coverage was achieved. Other outcomes included how much the gum recession improved, changes in gum thickness, and whether gum tissue successfully covered mild furcation defects in molars. Overall, connective tissue grafts showed better results than human-derived tissues. Teeth treated with connective tissue grafts were more likely to achieve complete root coverage and showed greater improvement in gum recession depth. Connective tissue grafts also more frequently repaired furcation defects. Both materials were similarly effective at improving gum tissue thickness. Treatment success was also influenced by initial recession type, the presence of furcation defects before surgery, initial gum thickness, and grafting material used.