Abstract: Gingival recession is a common manifestation of periodontal disease，which is highly prevalent and often associated with tooth sensitivity，root caries，non-carious cervical lesions on the exposed root surface，impiring esthetics. Treatment for Miller class Ⅲ gingival recession has been a clinical challenge. In recent years，the vestibular incision subperiosteal tunnel access（VISTA）has gradually attracted the attention of dentists and scholars. VISTA combined with subepithelial connective tissue graft（SCTG）can effectively cover the root surface，increase the thickness of soft tissues and width of keratinized tissue，and reduce the range of the surgical operation area and postoperative pain. The article showed a case of Miller class Ⅲ gingival recession in the lower anterior tooth with excessive lip frenulum attachment，which was treated with VISTA combined with SCTG and frenectomy at the same time. Details of treatment process and clinical decision-making process were illustrated. The patients were followed up for 12 months after surgery，and the effect of root coverage was evaluated with the help of digital technology. This case provided clinical experience for the treatment of such patients.

Key words: vestibular incision subperiosteal tunnel access, subepithelial connective tissue graft, gingival recession, root surface coverage

摘要： 牙龈退缩作为牙周炎最常见的伴发病变，其发病率高，根面暴露不仅影响美观，还会导致牙齿敏感、根面龋及牙体缺损等问题。治疗同时伴有邻面附着丧失的Miller Ⅲ度牙龈退缩一直是临床上具有挑战性的难题。近年来，经前庭沟切口的骨膜下隧道技术（vestibular incision subperiosteal tunnel access，VISTA）逐渐受到医生与学者的关注，VISTA与上皮下结缔组织移植术（subepithelial connective tissue graft，SCTG）联合应用，在有效覆盖根面的同时，增加软组织厚度及角化龈宽度，亦可减少术区范围及术后疼痛等并发症的发生。文章展示了1例下前牙区单牙Miller Ⅲ度牙龈退缩并伴下唇系带附着位置过高病例的临床决策及治疗过程，详细介绍了VISTA联合SCTG的膜龈术式对裸露根面进行覆盖，并同期行系带切除术的技术细节。术后追踪随访12个月，并借助口腔数字化技术评价根面覆盖效果，为此类病例的临床处置积累了一定经验。

关键词: 经前庭沟切口的骨膜下隧道技术, 上皮下结缔组织移植术, 牙龈退缩, 根面覆盖