Recreating Pink Aesthetics: Modified VISTA Technique for Gingival Recession & Phenotype Enhancement with Platelet Concentrates

OBJECTIVES: The increasing demand for aesthetically pleasing outcomes in periodontal therapy underscores the need for refined, minimally invasive surgical techniques. Among the various periodontal plastic surgery procedures, root coverage for gingival recession remains one of the most challenging and technique-sensitive treatments. This study aims to assess the efficacy of the Modified-Vestibular Incision Subperiosteal Tunnel Access (M-VISTA) technique combined with autologous platelet-rich fibrin (PRF) in treating Miller Class I gingival recession. The objectives include evaluating the ability of this combined approach to achieve root coverage coronal to the cementoenamel junction, enhance the gingival phenotype, and provide satisfactory esthetic results.

MATERIALS AND METHODS: The case series included patients aged 27–35 years who presented with Miller Class I gingival recession in the mandibular anterior region. All patients had intact interdental papillae, no interproximal bone loss, and no tooth mobility. The modified VISTA technique was employed to create a mucoperiosteal tunnel via two buccal incisions. Autologous PRF membranes were then placed within the tunnel to aid tissue regeneration and improve healing. Suturing was performed using a vertical double-crossed suture technique with 5-0 Vicryl sutures. Postoperative care and follow-up visits were conducted to monitor healing and assess clinical outcomes such as root coverage, tissue regeneration, and patient satisfaction.

RESULTS AND DISCUSSION: The combined use of the M-VISTA technique and PRF resulted in complete root coverage in all cases, with significant esthetic improvement in the treated areas. The PRF membrane facilitated tissue regeneration, reducing inflammation and promoting quicker healing. No complications, such as infection or graft failure, were observed. The results showed substantial increases in keratinized tissue width and improved gingival appearance. Patient satisfaction was high, with most reporting favorable esthetic results and minimal discomfort. The outcomes suggest that the M-VISTA-PRF approach is a reliable, effective, and minimally invasive treatment for Miller Class I gingival recession, offering both functional and esthetic improvements.

CONCLUSIONS: The Modified-Vestibular Incision Subperiosteal Tunnel Access (M-VISTA) technique, augmented with autologous platelet-rich fibrin (PRF), provides a promising, minimally invasive treatment option for Miller Class I gingival recession. This technique achieves complete root coverage and enhances the gingival phenotype, providing significant esthetic benefits. The use of PRF improves tissue healing and regeneration, resulting in more stable and lasting clinical outcomes. The combined M-VISTA-PRF approach is a valuable addition to periodontal plastic surgery, offering patients a conservative yet effective solution for gingival recession with enhanced healing and reduced postoperative discomfort.

CLINICAL SIGNIFICANCE: The M-VISTA technique with PRF offers a novel, effective, and minimally invasive solution for the treatment of localized gingival recession. This method improves both the functional and esthetic aspects of gingival restoration, providing a more natural appearance while promoting tissue regeneration. The use of PRF accelerates healing, reduces inflammation, and optimizes the quality of newly formed tissue. The technique is well-suited for patients seeking esthetic improvement in the anterior region, offering high patient satisfaction with reduced recovery time and minimal discomfort.

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