BACKGROUND: To compare the clinical, esthetic, and patient-reported outcomes of the vestibular incision subperiosteal tunnel access (VISTA) technique and the modified tunnel (mTunnel) technique, both combined with connective tissue grafts (CTGs), for treating recession type 1 (RT1) single gingival recessions. METHODS: A total of 24 patients with single non-molar RT1 recessions were randomly assigned to the VISTA + CTG or the mTunnel + CTG group. A blinded examiner assessed the recession reduction (RecRed), mean root coverage (MRC), complete root coverage (CRC), keratinized tissue width, patient-reported outcomes, and root coverage esthetic score (RES). RESULTS: At 12 months, both groups achieved significant recession reduction. However, there were no significant differences in RecRed and MRC between the groups (VISTA: 2.38 ± 0.96 mm and 90.28 ± 18.06%, mTunnel: 2.08 ± 1.10 mm and 81.25 ± 29.16%
P = 1 and P = 0.834, respectively). The CRC was significantly higher in the VISTA group (VISTA: 75%, mTunnel: 50%
P <
0.001). Both groups obtained high RES scores (VISTA: 8.75 ± 1.14, mTunnel: 7.75 ± 2.99, P = 0.786), but the mTunnel group demonstrated significantly less scar formation (P = 0.014). CONCLUSIONS: Both procedures effectively treated single RT1 recessions at 12-months follow-up. However, the VISTA technique demonstrated superior CRC results compared to the modified tunnel technique. TRIAL REGISTRATION: The trial had been registered prospectively at http://www.chictr.org.cn on 19/12/2015 (Registration number: ChiCTR-INR-16007845), and structured according to the CONSORT statement.