Does a vestibular incision improve tunnel technique outcomes? A randomized clinical trial of the treatment of recession type 1 single gingival recessions

Background To compare the clinical, esthetic, and patient-reported outcomes of the vestibular incision subperiosteal tunnel access (VISTA) technique and the modified tunnel (mTunnel) technique, both combined with connective tissue grafts (CTGs), for treating recession type 1 (RT1) single gingival recessions. Methods A total of 24 patients with single non-molar RT1 recessions were randomly assigned to the VISTA + CTG or the mTunnel + CTG group. A blinded examiner assessed the recession reduction (RecRed), mean root coverage (MRC), complete root coverage (CRC), keratinized tissue width, patient-reported outcomes, and root coverage esthetic score (RES). Results At 12 months, both groups achieved significant recession reduction. However, there were no significant differences in RecRed and MRC between the groups (VISTA: 2.38 ± 0.96 mm and 90.28 ± 18.06%, mTunnel: 2.08 ± 1.10 mm and 81.25 ± 29.16%; P  = 1 and P  = 0.834, respectively). The CRC was significantly higher in the VISTA group (VISTA: 75%, mTunnel: 50%; P  < 0.001). Both groups obtained high RES scores (VISTA: 8.75 ± 1.14, mTunnel: 7.75 ± 2.99, P  = 0.786), but the mTunnel group demonstrated significantly less scar formation ( P  = 0.014). Conclusions Both procedures effectively reduced recession in single RT1 recessions at 12-months. The VISTA technique, however, showed superior CRC results, though with increased scar formation at the vertical incision site. Trial registration: The trial had been registered prospectively at http://www.chictr.org.cnon19/12/2015 (Registration number: ChiCTR-INR-16007845), and structured according to the CONSORT statement.