A Thirty-Seven-Year Retrospective Assessment of Connective Tissue Grafting: What Have We Learned? A Case Report.

Abstract

Objective: This case report presents the thirty-seven-year follow-up results of a gingival recession (GR) treatment in the maxillary esthetic zone.

Case description: In 1987, a healthy twenty-year-old female with a history of orthodontic treatment presented with a chief complaint of GR on the facial area of #9. There was no occlusal trauma, hypersensitivity, or parafunctional habit. Clinically, there was 4mm GR on the facial surface, classified as Miller's Class I (RT1), with a probing depth of 1mm, without bleeding on probing. A partial thickness flap was reflected around the teeth to be grafted. The donor site (palate) provided a subepithelial connective tissue graft (CTG), as per the Langer and Langer protocol. A 2mm thick graft was harvested and surgically placed on the recipient side; the flap was then repositioned. The patient was evaluated after 6 months (GR: -0.5mm), twenty-seven years (GR: 1.0mm), and thirty-seven years (GR: 1.5mm). This was a successful long-term result. However, a relapse was noted, possibly exacerbated by orthodontic treatment associated with the thin overall phenotype in both arches.

Conclusion: SCTG is a safe and effective modality for long-term root coverage, demonstrating tissue stability, thickness gain, and complete root coverage within six months after the procedure. A relapse of approximately 1.5 mm was noted on the facial surface after thirty-seven years.