Double-Vestibular Incision Tunnel Technique With Platelet-Rich Fibrin and Connective Tissue Graft for Mandibular Anterior Gingival Recession: A Case Series

Gingival recession (GR), also known as the migration of the gingival margin in an apical direction beyond the cementoenamel junction (CEJ), is not merely an esthetic problem. It may also cause cervical lesions, increased susceptibility to root-surface caries, hypersensitivity, and compromised periodontal health. These defects can be multifactorial and often occur more commonly in the mandibular anterior region. Due to the technique sensitivity of standard approaches, there is a growing inclination towards minimally invasive techniques for managing multiple GR defects, especially in this area. Two systematically healthy male patients, aged 39 and 45 years, reported with multiple recession-type (RT) 1 and RT2 gingival recessions in the mandibular anterior region. Both cases underwent the novel double-vestibular incision subperiosteal tunnel access (double-VISTA) technique with placement of platelet-rich fibrin (PRF) and subepithelial connective tissue graft (SCTG), respectively. Double-VISTA, along with PRF or SCTG, proved to be a reliable procedure for the management of multiple GR defects in the mandibular anterior region. Both cases showed excellent improvements in clinical parameters. Within the limitations of the case series, PRF may serve as an effective substitute for SCTG in the double-VISTA approach. However, further larger-sample-size studies are required to confirm its sustainability and predictability.