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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.

egyptian dental journal /egyptian dental journal

Comparative clinical study between Tunnel and VISTA approaches for the treatment of multiple gingival recessions with acellular dermal matrix allograft