Evaluating and comparing the efficacy of the microsurgical approach and the conventional approach for the periodontal flap surgical procedure: A randomized controlled trial.

BACKGROUND: The use of the magnification approach for the periodontal flap surgical procedure helps in better visualization and better handling of soft tissues, which results in early wound healing. OBJECTIVES: The aim of the present study was to compare the conventional macroscopic approach for periodontal flap surgery with the microsurgically modified approach in a randomized controlled clinical trial. MATERIAL AND METHODS: A total of 60 subjects were randomly divided into 2 groups: group A (test group), in which the subjects underwent the conventional open flap debridement procedure; and group B (control group), in which the subjects underwent open flap debridement with the use of a microsurgical loupe. The plaque index (PI), the gingival index (GI), the probing pocket depth (PPD), the clinical attachment level (CAL), and gingival recession (GR) were recorded at baseline, and at 3, 6 and 9 months postoperatively. Also, the early wound-healing index (EHI) was recorded at 10 days postoperatively. RESULTS: Both the conventional and the microsurgical technique provided a statistically significant reduction in PI, GI and PPD as well as gain in CAL. However, the microsurgical technique demonstrated a statistically significant decrease in postoperative GR as well as reduced pain perception and EHI scores. CONCLUSIONS: The use of the microsurgical approach provides better clinical results with less discomfort, and thus makes the periodontal treatment more acceptable for the patient.

Vestibular Incision Subperiosteal Tunnel Access with Titanium-Prepared Platelet-Rich Fibrin - A Golden Approach for Treating Multiple Recession Defects in Esthetic Zone.

Gingival recession is defined as apical migration of marginal gingival tissue causing the exposure of root surface. Abnormal brushing techniques, trauma, anatomical presence of tooth, caries, and improper oral hygiene measures are some of the problems leading to gingival recession. Several treatment modalities such as coronary advanced flaps and free gingival grafts have been used for the treatment of gingival recession defects and showed good results. However, while treating multiple gingival recessions, some new treatment modalities were introduced in literature. Vestibular incision subperiosteal tunnel access (VISTA) as a minimally invasive technique for root coverage was introduced with various advantages such as no secondary surgical site needed for harvestment of donor tissue and it provides excellent esthetic results with decreased patient morbidity. The present case report emphasizes on the treatment of multiple gingival recessions in the maxillary anterior teeth region using VISTA with titanium-prepared platelet-rich fibrin.