A Vestibular Tunnel Strategy for Multiple Maxillary Anterior Gingival Recessions Using Vestibular Incision Subperiosteal Tunnel Access and Subepithelial Connective Tissue Grafting

Abstract

This case report describes the management of multiple adjacent gingival recession defects in the maxillary anterior region using the Vestibular Incision Subperiosteal Tunnel Access (VISTA) technique in combination with a subepithelial connective tissue graft (SCTG). VISTA is a minimally invasive periodontal plastic surgery approach that enables subperiosteal tunnel preparation and coronal advancement of the gingival tissues through a remote vestibular access incision, thereby preserving the integrity of the interdental papillae. In the present case, an autogenous SCTG was incorporated to enhance soft-tissue thickness and improve the quality and stability of the augmented gingival tissue. The combined approach was selected to minimize surgical trauma while providing predictable root coverage and satisfactory esthetic outcomes across multiple contiguous recession defects. Healing was uneventful, and favorable clinical results were observed during postoperative follow-up. Nevertheless, longer-term clinical evaluation and further studies involving larger patient populations are required to establish the predictability and applicability of this technique across different clinical presentations.