Human histology of new attachment after root coverage using subepithelial connective tissue graft

Background, aims: Connective tissue grafts are used successfully in periodo ntal therapy for root coverage. However, reports on the histologic interfac e between the root surface and the grafted tissue have been few in number. This report describes a case study in which a subepithelial connective tiss ue graft was placed in a 27-year-old female on the maxillary left side. Methods: The graft (15 mm long, 10 mm wide, 1.5 mm thick) included palatal periosteum and was placed with the periosteal side facing the exposed bone and root surfaces. Results: 15 weeks after grafting, the teeth presented with residual recessi ons of 1 mm, and buccal probing depths were approximately 1 mm. 14 months p ostsurgery the 1st maxillary premolars on both sides were extracted for ort hodontic therapy. Clinical parameters at the graft site remained as at 15 w eeks, Histologic analysis of tooth #24 showed that the sulcular epithelium was keratinized; epithelium lining the dentin exhibited rete ridges project ing Into the gingival connective tissue; and junctional epithelium extended over new cementum. New connective tissue attachment was also observed, inc luding periodontal ligament. Conclusion: Biological width was comparable pre- and post-surgery, indicati ng a real gain in attachment of 3.9 mm.