The connective tissue graft wall technique to improve root coverage and clinical attachment levels in lingual gingival defects

The present case report describes the application of the connective tissue graft wall (CTGW) technique for the treatment of deep lingual gingival recessions associated with probing pockets and bone loss. Two deep lingual gingival recessions affecting the mandibular central incisors associated with severe lingual attachment and bone loss were treated. The surgical technique comprised a connective tissue graft (CTG) placed below a trapezoidal-type coronally advanced flap (CAF) acting as a lingual soft tissue wall of the infrabony defect. One year after the surgery, clinically significant root coverage, an increase in lingual keratinized tissue (KT) height and thickness, and clinical attachment level gain were achieved in both treated teeth. This case report encourages the application of the CTGW technique to improve both root coverage and regenerative parameters in lingual gingival recessions associated with severe attachment and bone loss.