Patient-centered comparative outcome analysis of platelet-rich fibrin-reinforced vestibular incision subperiosteal tunnel access technique and Zucchelli's technique

Abstract

Background: Multiple gingival recession (MGR) coverage, especially in esthetic area, demands a high patient satisfaction. Coronally advanced flap modifications, namely Zucchelli's technique (ZT) and vestibular incision subperiosteal tunnel access (VISTA), are techniques, recommended in the correction of MGR. Aim: The purpose was to comparatively analyze the ZT and VISTA technique reinforced with the platelet-rich fibrin membrane in the management of MGR. Materials and Methods: This split-mouth, randomized study comprised 16 consenting, systemically healthy participants. The bilateral Miller's multiple class I and II lesions were managed with ZT and VISTA technique and had a follow-up period of 18 months. Gingival thickness (GT), mean percentage of root coverage, and patient-centered outcome scales, including patient comfort score, patient esthetic score, and hypersensitivity score, were the primary outcome measures. Further clinical parameters assessed were gingival index, probing depth, clinical attachment level, and width of keratinized gingiva. Statistical Analysis and Results: Paired t -test and unpaired t -test were used for intragroup comparison and intergroup analysis, respectively. While both the techniques exhibited high root coverage percentage (VISTA: 93.95% and ZT: 96.84%), statistically significant difference was noted with patient esthetic score and surgical mortality score in VISTA. Conclusion: Both ZT and VISTA were effective in terms of root coverage and GT augmentation in MGR management. From the patient's perspective, they preferred VISTA technique over ZT, stating its minimal postoperative morbidity and improved esthetic outcome. Hence, within the limitations of this study, the VISTA technique was found to be a superior alternative compared to that of ZT in MGR management.

Liquid platelet‐rich fibrin in root surface biomodification during gingival recession treatment: Randomized, controlled, split‐mouth, clinical trial

“…The study was powered to detect a minimum clinically significant difference of 1 mm in recession depth (RD) levels using α = 0.05, a power = 80%, obtained from previous studies (McGuire & Scheyer, 2010 ; Rajeswari et al, 2021 ). By using G Power 3.1 (Heinrich‐Heine‐Universität), as a minimum, 14 patients (28 surgical sites) were needed.…”

¨[Original in spanish] Update of techniques for the treatment of periodontal recessions.

“…It consisted of a single vestibular incision, performed about 3 mm from the gingival margin, split thickness elevation of the attached gingiva and a tunnel carried out in the papillary areas. Finally, the whole complex was advanced coronally (Rajeswari et al, 2021;Mansouri et al, 2019).…”

“…accomplishes a greater CRC (93%), compared to that reported by the CAF technique (even in its association with a CTG), minimizes invasiveness, eases the procedure and reduces the surgical chair time, decreases the patient's pain perception and discomfort during and after the treatment, (Rajeswari et al, 2021;Mansouri et al, 2019). This procedure usually manifests a minimal discomfort during the surgical procedure, as well as a negligible pain after the intervention (VAS 75).…”

Actualización de las Técnicas para el Tratamiento de las Recesiones Periodontales

“…Acceso vía túnel subperióstico con incisión vestibular (VISTA): Consistió en una única incisión vestibular, realizada a unos 3 mm del margen gingival, seguida por la elevación de espesor parcial de la encía adherida, un túnel realizado en las áreas papilares y, finalmente, el avance coronal de todo el complejo (Rajeswari et al, 2021;Mansouri et al, 2019).…”