J Periodontal Implant Sci.
2022 Dec;52(6):466-478. 10.5051/jpis.2105760288.
Clinical and patient-reported outcomes after recession coverage using modified vestibular incision subperiosteal tunnel access with a volume-stable collagen matrix as compared to a coronally advanced flap with a subepithelial connective tissue graft
- Affiliations
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- 1Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, Houston, TX, USA
- 2Columbia University College of Dental Medicine, New York, NY, USA
- 3Section of Geriodontics, Department of Conservative Dentistry and Periodontology, Center of Dental Medicine, University Hospital Jena, Friedrich Schiller University, Jena, Germany
- 4Private Office, Arlington, VA, USA
- KMID: 2557545
- DOI: http://doi.org/10.5051/jpis.2105760288
Abstract
- Purpose
Coronally advanced split-or full-thickness (CAST or CAFT) flaps in combination with subepithelial connective tissue grafts (SCTGs) are commonly used in root-coverage procedures despite postoperative pain and bleeding from the graft donor site. Therefore, the modified vestibular incision subperiosteal tunnel access procedure (VISTAX) uses a novel collagen matrix (VCMX) instead of autogenous tissue to address the limitations associated with autogenous tissue grafting. This retrospective study compared the clinical outcomes of VISTAX to the results obtained after using a CAST or CAFT flap in combination with SCTG for root coverage.
Methods
Patients with single or multiple adjacent recession I/II defects were included, with 10 subjects each in the VISTAX, CAFT, and CAST groups. Defect coverage, keratinized tissue width, esthetic scores, and patients’ perceived pain and dentinal hypersensitivity (visual analogue scale [VAS]) were assessed at baseline, 3 months, and 6 months.
Results
All surgical techniques significantly reduced gingival recession (P<0.0001). Defect coverage, esthetic appearance, and the reduction in dentinal hypersensitivity were comparable. However, the VAS scores for pain were significantly lower in the VISTAX group than in the CAFT and CAST groups, which had similar scores (P<0.05). Furthermore, the clinical results of VISTAX and CAFT/CAST generally remained stable at 6 months.
Conclusions
The clinical outcomes of VISTAX, CAFT, and CAST were comparable. However, patients perceived significantly less pain after VISTAX, indicating a potentially higher patient acceptance of the procedure. A prospective trial with a longer follow-up period and a larger sample size should therefore evaluate VISTAX further.
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