Simplified Subperiosteal Sling Suture for Connective Tissue Graft Stabilization in Root Coverage and Phenotype Modification

This technical report describes the simplified subperiosteal sling (SPS) suture for connective tissue graft (CTG) stabilization in root coverage and phenotype modification of single and multiple reces-sion defects via the vestibular incisional subperiosteal tunnel access (VISTA). The simplified SPS suture engages only the CTG and stabilizes it to the tooth in the coronal-most position, inside the subperiosteal tunnel, independent of the overlying gingival tissue. The simplified SPS suture differs from the original SPS suture in that it engages the CTG first, and the needle and tail of the suture are knotted before the suture is introduced into the subperiosteal tunnel. This allows the needle to pass through the subperiosteal tunnel only once from the vestibular access to the intended gingi-val sulcus. When multiple teeth are treated, only one simplified SPS suture traverses the vestibular access at a time, as the CTG is incrementally advanced into the tunnel. This prevents suture entan-glement and improves the practical application of the technique. Int J Periodontics Restorative Dent 2024;44:569-577. doi: 10.11607/prd.6843