PREDICTABLE ROOT COVERAGE OF MULTIPLE GINGIVAL RECESSION BY A MODIFIED VISTA (VESTIBULAR INCISION SUPRA-PERIOSTEAL TUNNEL ACCESS) TECHNIQUE: A CASE REPORT

Objective: To present a case report where root coverage was performed by a modification of the vestibular incision supra-periosteal tunnel access (VISTA). The modifications of the original technique were the presence of incisions in the posterior region and the insertion of the graft from such incisions, reducing the chances of flap and papilla laceration. The technique was chosen based on the need for a conservative and predictable procedure, since the patient had a thin phenotype and gingival recessions measuring up to 4 mm. Material and Methods: A female patient, 45 years old, presented multiple Cairo RT1 recessions in the region of teeth 14 to 24 (maxilla) and 34 to 45 (mandible). Thus, the treatment proposed was tunneling associated with the modified VISTA technique, combined with a subepithelial connective tissue graft and covering the donor area using PRF membranes covered with a Hawley plate. Postoperative pain was measured using the Visual Analogue Scale (VAS) questionnaire. Results: At the post-surgical clinical examination, it was possible to notice the total root coverage of the treated region. The patient presented low levels of pain on the 3rd, 7th and 14th day after the procedure. Conclusion: The VISTA technique associated with tunneling is a predictable and minimally invasive alternative to the treatment of multiple RT1 recessions. The use of PRF associated with a palatal plate favored healing, in addition to provide comfort to the patient in the postoperative period.