Root Coverage Surgery with Subepithelial Connective Tissue Graft in the Treatment of Gingival Recession: A Clinical Case Report

Abstract

Gingival recession, a common periodontal condition, occurs when the gingival margin migrates apically to the cementoenamel junction (CEJ), exposing the root and potentially causing dental hypersensitivity, caries, and aesthetic dissatisfaction. Causes include bacterial biofilm, frenulum and frenum insertions, band of keratinized gingiva, gingival phenotype, alveolar morphology, tooth positioning, and mechanical trauma. It is classified into three types: RT1 (no CEJ exposure), RT2 (interproximal loss equal to or less than buccal loss), and RT3 (interproximal loss greater than buccal loss). Among root coverage techniques, the subepithelial connective tissue graft (SCTG) is highlighted for its predictability, color compatibility with adjacent gingival tissue, and good blood supply, reducing the likelihood of necrosis. This qualitative and descriptive study reported a clinical case of root coverage surgery with SCTG in a 60-year-old female patient with Miller class III and Cairo RT2 recessions on teeth 31 and 41. The palate was chosen as the donor site for the graft due to its adequate thickness. The SCTG technique combined with a laterally positioned flap and double papilla was used. The procedure resulted in reduced dentinal hypersensitivity and patient satisfaction with aesthetics, along with an increase in keratinized tissue, despite not achieving total root coverage. The success of the treatment was attributed to the precise indication of the case and professional skill.