Effectiveness of the Vestibular Incision Subperiosteal Tunnel Access (VISTA) technique in the treatment of multiple gingival recessions: A systematic review and meta-analysis

Abstract

Background: In 2011, Zadeh proposed the use of a minimally invasive vestibular incision subperiosteal tunnel access technique (VISTA) to overcome the limitations of the intrasulcular tunneling procedure for root coverage and introduced the use of recombinant growth factor technology to overcome the limitations of autogenous soft tissue graft. Up-to-date evidence on the efficacy of VISTA has not yet been addressed. Therefore, the aim of the present systematic review and meta-analysis is to compare the results of root coverage procedures between VISTA and other root coverage procedures, investigate the predictability and efficacy of the VISTA technique in the treatment of multiple gingival recessions, and assess the use of human platelet-derived growth factor BB (rhPDGF-BB) associated with VISTA vs. connective tissue graft or other alternatives. Methods: A literature search on MEDLINE was carried out via PubMed and Ovid from 2011 to June 2022 to identify clinical studies investigating VISTA for root coverage procedures. Only randomized controlled trials (RCT) published in English were considered for the meta-analysis comparing VISTA with CAF or it is modification. Results: A total of five articles were included in the systematic review and three in the meta-analysis. None of the RCTs were classified as low risk of bias. VISTA and CAF had a comparable reduction in recession depth (RD), clinical attachment gain (CAL) when varying combinations of graft materials were evaluated. However, CAF demonstrated superior results to VISTA in mean root coverage and keratinized tissue gain. Conclusions When the data were quantitatively analysed, VISTA was not determined to be superior to CAF. However, due to insufficient research comparing VISTA with CAF, the findings on the best treatment for root coverage are inconclusive.