Tehran University of Medical Sciences Frontiers in Dentistry 2676-296X 22 0 2025 06 02 4494 4494 EN Jaber Yaghini Department of Periodontics, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran Mehrnegar Mahmoudzadeh Department of Periodontics, School of Medicine, Arak University of Medical Sciences, Arak, Iran Zohreh Afshari Department of Periodontics, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran Amir Farmohammadi Private practice, Isfahan, Iran Ahmad Mogharehabed Department of Periodontics, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran 2022 06 04 2024 07 10 Objectives: The purpose of this study was to compare the clinical performance of coronally advanced flap (CAF) with connective tissue graft (CTG) and vestibular incision subperiosteal tunnel access (VISTA). Materials and Methods: The statistical population of this randomized clinical trial consisted of 24 healthy non-smokers with Miller Class I or II gingival recession (GR) defects, equally divided into two groups of 12 to receive either a CAF or the VISTA technique. Clinical parameters including the clinical attachment level (CAL), gingival biotype, pocket probing depth (PPD), recession height (RH), recession width (RW), root coverage (RC), and keratinized tissue width (KTW) were measured and compared between the two groups using ANCOVA, Fisher's exact test, independent samples t-test, Mann-Whitney U test, and repeated-measures ANOVA (alpha=0.05). Results: The CAF group showed a significantly higher RC percentage (97.22%±9.62%) than the VISTA group (77.22%±24.28%%). Both techniques exhibited similar performance in terms of reducing the PPD and increasing the KTW and gingival attachment. However, the CAF group experienced a significantly greater reduction in CAL, RW, and RH than the VISTA group (P<0.05). Conclusion: The VISTA and CAF groups showed a complete root coverage (CRC) percentage of 33.3% and 91.7%, respectively, indicating higher effectiveness of CAF than VISTA. https://fid.tums.ac.ir/index.php/fid/article/view/4494 https://fid.tums.ac.ir/index.php/fid/article/download/4494/2150