الفهرس 
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Abstract
Gingival recession is defined as the apical migration of the gingival margin below the cement-enamel junction (CEJ) resulting in exposure of the root surface. It can be localized or generalized.
The management of gingival recession depends on a comprehensive assessment of the etiological causes and the amount of tissue envelopment.
The Technique used for the treatment of recession is The VISTA technique which is essentially a modification of the double-layer tunneling technique that requires a single incision serving in the creation of the subperiosteal tunnel flap and an opening for the graft.
The minimally invasive VISTA approach combined with or without a broad wound-healing growth factor affords several unique advantages to the successful treatment of multiple recession defects.
The VISTA approach overcomes some of the shortcomings of intracellular tunneling techniques used for periodontal root coverage. In the VISTA technique, access is broader and is made in the vestibule, where a single vestibular incision can provide access to an entire region, including visual access to the underlying alveolar bone and root dehiscences. The remote incision reduces the possibility of traumatizing the gingiva of the teeth being treated.
The augmented material used either Platelet-rich fibrin (PRF) or a Non-pedicled buccal fat pad (NPBFP).
PRF belongs to the second generation of platelet concentrates with simplified processing.PRF preparation techniques require neither anticoagulant nor bovine thrombin.
PRF membrane can be considered an effective healing biomaterial. It features all the essential parameters permitting optimal healing. PRF membrane consists of a fibrin 3D mesh polymerized in a specific structure; the incorporation of platelets, leukocytes, and growth factors; and the presence of circulating stem cells also, these growth factors have been shown to accelerate bone repair and promote fibroblastic proliferation along with an increase in tissue vascularization.
Placements of PRF membrane in recession defects have been found to repair gingival defects, re-establish the continuity and integrity of the keratinized gingiva, and increasing the gingival thickness.
Another biological mediator which is used to treat recession is a buccal fat pad which is non- pedicled. BFP is also used in the defects resulting from traumatic or malignant tumors in oral soft tissue and for treatment of recession. Advantages of using BFP are that it is a quick, simple, and easy flap to use, heals with minimal scarring, negligible morbidity, and the failure rate is very low. However, reported complications with BFP reconstruction are bleeding, hematoma, partial necrosis, excessive scarring, and infection. BFP that can aid in periodontal regeneration due to presence of stem cell.
Forty patients aged between 21 years and 45 years were enrolled in the study of a total of forty gingival recessions comprising of 34 anterior teeth and 6 premolars were treated with the VISTA technique either with BFP or PRF.
In both groups, all clinical parameters were statistically significant from the pre-operative period till 6 months follow-up period. In the comparison between the two groups after 6 months follow up period, there was no statistically significant difference between the two groups regarding all clinical parameters except the percentage of root coverage; there was a significant increase in the percentage of root coverage after 3 and 6 months follow up period in group II.