Histology of connective tissue graft. A case report

Background: Few investigations can be found in the literature on the histol ogical nature of the attachment of connective tissue grafts to root surface s previously exposed by recession. Methods: In this case report, a 24-year-old patient was treated with a conn ective tissue graft combined with a partial-thickness coronally positioned flap for root coverage of Class 1 Miller recessions at the maxillary right and left canines and first premolars. The treated sites exhibited 83% and 1 00% root coverage on the right and left sides, respectively. Twelve months later, the case required extraction of all 4 first premolars for orthodonti c reasons. Two conservative block sections including the maxillary first pr emolars with the buccal soft tissues were obtained and processed histologic ally in a bucco-palatal plane. Results: Histological analysis showed that healing occurred via a long juct ional epithelium throughout the major portion of the previous recession sit e. Only minimal signs of new cementum-like tissue formation could be seen i n the apical portion of the recession area coronal to the base of the instr umented root surface. No root resorption or ankylosis could be detected in any of the serial sections. Conclusions: The findings of this case report outline the possible variatio ns in the histological outcome of connective tissue grafts. These variation s can be attributed to differences in size and shape of the recession defec ts and flap positioning at the end of surgery.