Comparative evaluation of vestibular incision subperiosteal tunnel access (VISTA) technique with and without A-PRF impregnated with DFDBA in the treatment of recession defects in maxillary anterior region: a randomized controlled trial.

OBJECTIVES: The present randomized controlled trial was planned to compare the effectiveness of the Vestibular incision subperiosteal tunnel access (VISTA) performed alone and VISTA with Advanced platelet-rich fibrin (A-PRF) impregnated with Demineralized freeze-dried bone allograft (DFDBA) for the management of multiple adjacent gingival recession defects (MAGRD) in the maxillary anterior region. METHOD AND MATERIALS: Thirty patients exhibiting bilateral Miller's Class I and II recession defects were treated using a split-mouth protocol. Clinical evaluation included assessment of probing depth (PD), clinical attachment level (CAL), gingival recession depth (GRD), gingival recession width (GRW), width of keratinized gingiva (WKG), gingival thickness (GT), and percentage of root coverage (%RC) before treatment and reassessed at 3, 6, and 12 months postoperatively. Changes in labial plate thickness (LPT) were determined radiographically with cone beam computed tomography (CBCT) at baseline and after a 12-month follow-up period. RESULT: A-PRF impregnated with DFDBA resulted in more pronounced clinical benefits at 12 months, evidenced by gain in CAL (P< .001), greater reductions in GRD (P< .001) and GRW (P= .031), and an enhanced increase in the WKG, GT (P< .001) and % RC (P= .002). Radiographically, a significant increase in LPT (P< .001) in the Test group was observed as compared to the Control group at 1, 3 and 5 mm apical to CEJ. CONCLUSION: Both therapeutic approaches produced favourable clinical improvements over time. A-PRF impregnated with DFDBA may enhance the regenerative potential of VISTA and contributeto more predictable and stable esthetic outcomes.