Comparative Evaluation of Vestibular Incision Subperiosteal Tunnel Access (VISTA) Technique with other Tunneling Techniques: Protocol for a Systematic Review and Meta-analysis

Introduction: Gingival recession is defined as the displacement of the gingival margin apical to the Cementoenamel Junction (CEJ). The aim is to achieve complete root coverage. The increasing demand for aesthetics by patients has led dentists to adopt newer and more novel techniques. Since Allen first introduced the tunneling technique in 1994, several procedural adjustments have been suggested. The "Vestibular Incision SubperiostealPeriosteal Tunnel Access (VISTA)" technique was introduced by Zadeh HH and offers the benefit of being minimally invasive. Need for the study: This systematic review aims to guide clinicians in selecting the best possible root coverage procedure for better patient -centered outcomes. Aim: The aim is to compare the "VISTA technique" with other tunneling techniques in the treatment of multiple gingival recession defects. Materials and Methods: Up until December 2023, the authors will search PubMed, the Cochrane Library, and Embase without any language constraints. Additionally, reviewers will hand search and examine the bibliographies of relevant publications, search trial registries for active trials, and look for potentially relevant research. The keywords to be used for the search include VISTA technique, tunneling technique, root coverage procedure, and multiple gingival recession. Randomised Controlled Trials (RCTs) using an open or blinded assessment of outcomes will be included. Full journal publications will also be included. Exclusions will be made for brief abstracts (typically meeting reports), non randomised studies, research on experimental pain, studies based on animal models, and observational studies. The eligibility of each study will be independently determined by three review authors (SS, PD, RO). They will then extract the data and independently assess the Risk of Bias (RoB) for each study using the established Cochrane methodology. The evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE), and a summary of findings will be tabulated. The Preferred Reporting Items for Synthematic Reviews and Meta -Analyses (PRISMA) guidelines will be followed for present review.