Histologic Observation of Soft Tissue Acquired From Maxillary Tuberosity Area for Root Coverage

Abstract

The palatal area has been the major donor site for obtaining connective tissue for root-coverage procedures. This study evaluated the long-term outcome of using a gingival cuff from the maxillary tuberosity area as a donor site for root coverage procedures. Case 1: A 26-year-old female patient complaining of tooth hypersensitivity and gingival recession on the maxillary left canine was treated with root coverage using a pouch technique. A connective tissue graft was obtained from the gingival cuff of the maxillary tuberosity area. An additional gingivectomy was performed at 3 months after surgery to trim the bulk of the grafted tissue. Regular recall check-up visits, including oral hygiene maintenance, occurred every 6 months. The patient was followed for 35 months after surgery. Case 2: A 24-year-old female patient with a chief complaint of tooth hypersensitivity and multiple areas of gingival recession in the maxilla was treated with a pouch and semilunar technique. The patient was treated with the same surgical protocol as in case 1. The patient was followed for 31 months after surgery. Full coverage was achieved in both cases with uneventful healing. The gingival biotype changed from a thin scalloped biotype to a thick flat biotype, and the overall color match was successful. The histologic findings of case 1 revealed good adaptation of the grafted tissue with continuous epithelial lining into the recipient site. The grafted tissue remained consistently stable with no change in the probing depths. The long-term evaluation of root coverage with a gingival cuff of the maxillary tuberosity area showed it to be an easier method than obtaining the graft from palatal masticatory mucosa, with a highly predictable prognosis.