Reddy Saravanan Sampoornam Pape, Francis Delfin Lovelina, Harish Ruchi, Raja Kumara, Krishnan Shreehari Ambika, Chopra Sukhbir Singh, Manohar Balaji, Narayana Ravikiran, Lakshmyya Kesavalu
Classified Specialist (Periodontology), Army Dental Centre (Research & Referral), New Delhi, India.
Professor (Public Health Dentistry), Saveetha Dental College & Hospitals, Saveetha University, SIMATS, Chennai, Tamil Nadu, India.
Med J Armed Forces India. 2024 Jul-Aug;80(4):378-386. doi: 10.1016/j.mjafi.2024.04.010. Epub 2024 May 27.
Vestibular Incision Subperiosteal Tunnel Access (VISTA) root coverage technique has experienced a surge in popularity in recent times. The methodology employed in this study is characterized by its minimally invasive nature, utilizing a single incision. The primary objective of this systematic review was to assess the effectiveness of the VISTA approach for achieving root coverage. The protocol was registered with PROSPERO and included randomized controlled clinical trials where gingival recessions were managed with VISTA technique or its modifications. Among the total of 416 records, a mere 14 studies were initially deemed eligible for consideration. Ultimately, only eight pieces of research were included in the final analysis. There were six studies that exhibited heterogeneity, while two studies showed homogeneity and were therefore included in the meta-analysis. All of the studies considered in the analysis exhibited a moderate to low risk of bias. The majority of the research included in the analysis focused on selective root coverage outcome indicators, while neglecting to incorporate patient-reported outcome measures and patient experienced outcome measures. The VISTA procedure is commonly acknowledged as the most efficacious approach for managing gingival recession. The current literature provides support for the recommendation of the procedure, with evidence of intermediate certainty. The findings of this systematic review indicates that the available data are restricted due to several methodological limitations observed in the included studies. These limitations include, small sample sizes, selective reporting of outcomes, and very short follow-up periods.
前庭切口骨膜下隧道入路（VISTA）牙根覆盖技术近年来广受欢迎。本研究采用的方法具有微创性，仅使用单一切口。本系统评价的主要目的是评估VISTA方法实现牙根覆盖的有效性。该方案已在PROSPERO注册，纳入了采用VISTA技术或其改良方法治疗牙龈退缩的随机对照临床试验。在总共416条记录中，最初仅有14项研究被认为符合纳入标准。最终，仅有8项研究被纳入最终分析。有6项研究存在异质性，2项研究显示具有同质性，因此被纳入荟萃分析。分析中纳入的所有研究均显示出中度至低度偏倚风险。分析中纳入的大多数研究侧重于选择性牙根覆盖结局指标，而忽略纳入患者报告结局测量和患者体验结局测量。VISTA手术通常被认为是治疗牙龈退缩最有效的方法。当前文献为推荐该手术提供了支持，证据具有中等确定性。本系统评价的结果表明，由于纳入研究中观察到的若干方法学局限性，现有数据有限。这些局限性包括样本量小、结局选择性报告以及随访期非常短。
