Root coverage and papilla reconstruction using autogenous osseous and connective tissue grafts

Previous studies have reported that the distance from the interdental crest of bone to the apical portion of the contact of the two approximating teet h must be 5 mm or less to support a stable interdental papilla. The reconst ruction of a stable, longterm papilla for esthetic purposes must therefore consider interdental bone reconstruction. Autogenous osseous graft material was harvested from the tuberosity and augmented with a subperiosteal conne ctive tissue graft for papilla reconstruction between the maxillary central incisors. Flap design, osseous graft fixation with a screw, connective tis sue placement, wound closure, and suturing techniques are presented. To enh ance the final result, porcelain Veneers were bonded to the approximating c entral incisors. This case report demonstrates a surgical procedure that ha s not been reported to date for papilla reconstruction to enhance periodont al esthetics.