Dual role of subepithelial connective tissue grafting in regeneration of periodontal attachment apparatus

Gingival recession or marginal soft tissue recession is the displacement of the gingival margin apical to the cemento-enamel junction.¹ When gingival recession is combined with the presence of pathologically deep periodontal pocket depths and other periodontal parameters, the presentation becomes more complex. This can affect the aesthetic and functional aspects of the periodontal attachment apparatus. When such a combined defect is present, a thorough clinical and radiographic examination, precise diagnosis and meticulous treatment planning is of prime importance. Not all patients are suitable candidates for grafting and regenerative procedures and the clinical decision should be made entirely based on the particular patient diagnosis. Subepithelial connective tissue grafting has been used widely by periodontists in the treatment of gingival recession and as a barrier membrane in guided tissue regeneration therapy owing to its distinct advantages. The subepithelial connective tissue grafts have been highly predictable in gingival recession therapy with respect to a high percentage of root coverage, better healing and less post-operative discomfort at the donor site, when compared to free gingival grafts.² Also, colour-matching, in relation to the adjacent tissues, offers a clear advantage in comparison to the remaining methods.