Histologic observation of soft tissue acquired from maxillary tuberosity area for root coverage

Background: 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. Methods: 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 checkup 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. Results: 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. Conclusion: 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.