Introduction: Gingival recession results from apical migration of the gingival margin leading to root exposure with esthetical and functional problems. Treatment of gingival recession occurs through variable techniques as laterally positioned flaps, coronally advanced flaps, connective tissue graft, tunnel technique and guided tissue regeneration. Acellular Dermal Matrix allograft (ADM) is a safe alternative to autogenous grafts allows the treatment of multiple adjacent recessions. The tunnel technique (Tun) provides good vascularity with absence of the vertical releasing incision. Modification of tunnel technique, vestibular incision subperiosteal tunnel access (VISTA) preserve the papillary integrity and enhances patient's compliance. Materials and Methods:A split mouth study design was done on ten patients having bilaterally symmetrical maxillary or mandibular two to three adjacent Miller Class I or II gingival recession defects on canine or premolars. In each patient, gingival recession will be treated with VISTA+ADM at the right side and TUN+ADM at the left side.Results: After 6 months follow-up period a statistical significant difference exists between (VISTA+ADM) and (Tun+ADM) sides regarding recession heights and clinical attachment level in favor of (VISTA+ADM) technique. Also a statistically significant difference exists between baseline and 6 months follow-up measurements within each group regarding recession height, clinical attachment level, width of keratinized gingiva and probing depth.Conclusion: Acellular Dermal Matrix allograft is recommended in treatment of multiple gingival recessions. The combination of VISTA+ADM technique found to be more efficient than Tun+ ADM in treatment of Miller class I and II gingival recessions and led to favorable root coverage.

Introduction: Management of gingival enlargement starts with conventional periodontal treatment and might be followed by surgical intervention to return the gingiva to its normal anatomical and physiological contour. Gingivectomy can be done by various techniques as laser and electrocautery. Diode laser as a semiconductor transfer electrical energy into light energy allowing easy manipulation of soft tissue. Electrocautery is a controlled, precise application of heat used with carefully designed electrodes. Materials and Methods:A split mouth study design was done on ten patients having bilaterally symmetrical gingival hyperplasia in lower anterior teeth due to chronic inflammatory gingival enlargement. In each patient, gingivectomy was done with diode laser at the right side and electrocautery at the left side.Results: Intraoperative parameters included haemostasis and duration of surgery which showed no significant difference between both sides while laser showed significant improvement over electrocautery regarding instrument sticking. Postoperative parameters included pain which showed statically significant difference between both sides at 72hs in favor of electrocautery side, and healing index (HI) which showed no significant difference between both sides at 72hs, one week and one month postoperatively. Conclusion:Both treatment modalities were efficient in performing gingivectomy however, Electrocautery was superior to diode laser regarding postoperative pain and diode laser has advantage over electrocautery regarding instrument performance and showed better improvement in healing process.