---
title: m-VISTA Technique vs. CAF in the Treatment of Class III Multiple Recessions
nct_id: NCT03258996
overall_status: COMPLETED
phase: NA
sponsor: Aitziber Fernandez Jimenez
study_type: INTERVENTIONAL
primary_condition: Gingival Recessions
countries: Spain
canonical_url: "https://parkinsonspathways.com/agent/trials/NCT03258996.md"
clinicaltrials_gov: "https://clinicaltrials.gov/study/NCT03258996"
ct_last_update_post_date: 2022-03-08
last_seen_at: "2026-05-12T07:00:18.485Z"
source: ClinicalTrials.gov (mirrored, no enrichment)
---
# m-VISTA Technique vs. CAF in the Treatment of Class III Multiple Recessions

**Official Title:** Modified VISTA Technique Versus Coronally Advanced Flap in the Treatment of Class III Multiple Recessions: Randomized Clinical Trial

**NCT ID:** [NCT03258996](https://clinicaltrials.gov/study/NCT03258996)

## Key Facts

- **Status:** COMPLETED
- **Phase:** NA
- **Study Type:** INTERVENTIONAL
- **Target Enrollment:** 24
- **Lead Sponsor:** Aitziber Fernandez Jimenez
- **Conditions:** Gingival Recessions
- **Start Date:** 2017-12-04
- **Completion Date:** 2021-09-30
- **CT.gov Last Update:** 2022-03-08

## Brief Summary

The main objective is to assess whether the percentage of root coverage (%RC) achieved in the treatment of multiples class III recessions using the technique we have called modified vestibular incision subperiosteal tunnel access (m-VISTA), which is a lateral approach subperiosteal tunnel technique, combined with a connective tissue graft is greater than that achieved through the coronally advance flap (CAF) technique together with a connective tissue graft.

## Detailed Description

The reason for designing this study is that treatment of Class III gingival recessions (Miller 1985) continues to be challenging today and, although different techniques have been proposed to attempt to improve root coverage results, there is little evidence on what would offer better results.

To achieve those objectives a randomized controlled clinical trial is designed. Using the percentage of root coverage as a primary response variable, it is estimated with the calculation of the sample size, we would need 11 patients for each treatment group (Domenech and Granero 2010). In addition, taking into account possible drop-outs, we would increase the number of patients by recruiting a total of 24 patients.

A same experienced, blind and calibrated (the intraclass correlation coefficient will be at least of 0.75) examiner (R.E.) will collect the following periodontal clinical parameters at the baseline, and at 6 and 12 months, in each tooth involved, using a periodontal probe: Gingival recession, number and location of recessions to be treated, number of treated recessions that have a complete root coverage, the width of the gingival recession and the keratinized gingiva, the distance from the contact point to the interdental papilla, depth of probing, bleeding index and plaque index. And will also collect the opinion of the participant regarding pain and the degree of satisfaction with the aesthetic result.

Students of the University of the Basque Country's (UPV/EHU) Own Degree in Periodontology and Osteointegration will perform the corresponding surgical technique (m-VISTA or CAF) depending on the randomization sequence obtained. A clinical monitor (A.M.G.) will keep the sequence hidden until the moment of the intervention.

Initially, the subject will not know which technique to receive, the complete information regarding the surgical technique used, as the results obtained in his case, will be given in the last visit of the year.

Finally, a blind statistic (X.M) will analyze the data using the SPSS software, having as unit of analysis the subject. Doing a descriptive statistics, checking if the groups are homogeneous in basal, inter-group, intra-group and change variables comparisons and logistical regression to assess the intensity and duration of post-surgical pain adjusted for possible confounding factors.

## Eligibility

- **Minimum age:** 18 Years
- **Sex:** ALL
- **Healthy Volunteers:** Yes

```
Inclusion Criteria:

* Patients of the Master of Periodontology of the UPV / EHU.
* Age ≥ 18 years.
* Multiple recessions (more than two) Class III ≥ 2 mm deep, in which the interdental papilla does not extend beyond the cementoenamel line.
* Absence of active periodontal disease.
* Plaque index (O'Leary et al. 1972) and bleeding index (Ainamo and Bay 1975) ≤15%.
* Informed consent.

Exclusion Criteria:

* Smokers \> 10 cigarettes / day.
* Subjects with systemic conditions that contraindicate surgery.
* Subjects that have taken analgesics and anti-inflammatory drugs in the last 72 hours.
* Subjects taking opioids, anticonvulsants and antidepressants except serotonin selective inhibitors.
* Women who are pregnant or nursing.
* Patients who do not wish to participate in the study.
```

## Arms

- **Modified vestibular incision subperiosteal tunnel access** (EXPERIMENTAL) — Test group: Coverage of Class III multiples gingival recessions with the application of Modified vestibular incision subperiosteal tunnel access technique and a connective tissue graft from the palate.
- **Coronally advanced flap** (ACTIVE_COMPARATOR) — Control group: Coverage of Class III multiples gingival recessions with the application of Coronally advanced flap and a connective tissue graft from the palate.

## Interventions

- **Modified vestibular incision subperiosteal tunnel access** (PROCEDURE) — Single vertical mucosal incision, in the middel of the area to be treated, from which we began to lift a mucoperiosteal flap in a single plane.

With a micro-scalpel intrasulcular incisions are made extending to the base of the papillas.

Preparation of a tunnel in the same plane. Take a connective tissue graft on the same side of the palate. The connective graft is inserted through the vertical incision prepared with the aid of the suture.

All is stabilized by means of suspensory sutures of coronal traction on each point of contact.

Finally the vertical incision made is sutured.
- **Coronally advanced flap** (PROCEDURE) — Oblique submarginal incisions in both interdental areas of each recession, which continue with the intrasulcular incision, one tooth extending on each side of the teeth to be treated.

A partial-total-partial thickness flap is elevated in the coronal-apical direction.

A vestibular mucosal dissection is performed to eliminate muscle tension. The remnant tissue of the anatomical interdental papillas is desepithelized. Take a CTG on the same side of the palate. The connective tissue graft is stabilized with resorbable suture over the recessions with suspensory sutures on the teeth.

Finally, suspensory sutures with non-resorbable sutures are also used to achieve an accurate adaptation of the vestibular flap over the exposed root and stabilize each surgical papilla over each desepithelized interdental area.

## Primary Outcomes

- **Percentage of root coverage (%CR)** _(time frame: 12 months)_ — In each patient the mean of their gingival recessions at baseline (initial RECm) and at 12 months (RECm\_12 months) will be calculated. A new variable called %CR \[(RECm\_initial - RECm\_12 months) / (RECm\_initial x 100) will be calculated.

## Secondary Outcomes

- **Percentage of recessions with complete root coverage (%CRC)** _(time frame: 12 months)_
- **Post-surgical pain perception** _(time frame: After surgery up to 14 days)_
- **Gingival recession (REC)** _(time frame: Change from baseline at following surgery sixth and twelfth month respectively.)_
- **Post-surgical aesthetic result (VAS aesthetic)** _(time frame: 12 months)_
- **Pre-surgical pain perception** _(time frame: Baseline.)_
- **Post-surgical complications** _(time frame: After surgery first seven days.)_
- **Central Sensitization Inventory severity-level score of the subject** _(time frame: Baseline.)_
- **Number of recessions to be treated (NRT) Number of recessions to be treated (NRT)** _(time frame: Baseline.)_
- **Localization of the recessions to treat (LRT)** _(time frame: Baseline.)_
- **Gingival recession width (GRW)** _(time frame: Change from baseline at following surgery sixth and twelfth month respectively.)_
- **Keratinized gingiva width (KGW)** _(time frame: Change from baseline at following surgery sixth and twelfth month respectively.)_
- **Distance from contact point to the interdental papilla (CP-IP)** _(time frame: Change from baseline at following surgery sixth and twelfth month respectively.)_
- **Probing depth (PD)** _(time frame: Change from baseline at following surgery sixth and twelfth month respectively.)_
- **Patient bleeding index (BI)** _(time frame: Change from baseline at following surgery sixth and twelfth month respectively.)_
- **Patient plaque index (PI)** _(time frame: Change from baseline at following surgery sixth and twelfth month respectively.)_

## Locations (1)

- Department fo Stomatology II, Faculty of Medicine and Nursery, University of the Basque Country, Leioa, Biscay, Spain

## Recent Field Changes (last 30 days)

- `status.overallStatus` — added _(2026-05-12)_
- `status.primaryCompletionDate` — added _(2026-05-12)_
- `status.completionDate` — added _(2026-05-12)_
- `status.lastUpdatePostDate` — added _(2026-05-12)_
- `design.phases` — added _(2026-05-12)_
- `design.enrollmentCount` — added _(2026-05-12)_
- `eligibility.criteria` — added _(2026-05-12)_
- `eligibility.minAge` — added _(2026-05-12)_
- `eligibility.sex` — added _(2026-05-12)_
- `outcomes.primary` — added _(2026-05-12)_
- `outcomes.secondary` — added _(2026-05-12)_
- `armsInterventions.arms` — added _(2026-05-12)_
- `armsInterventions.interventions` — added _(2026-05-12)_
- `sponsor.lead` — added _(2026-05-12)_
- `results.hasResults` — added _(2026-05-12)_
- `locations.department fo stomatology ii, faculty of medicine and nursery, university of the basque country|leioa|biscay|spain` — added _(2026-05-12)_

---

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