Inverted T-shape free gingival graft for treatment of RT3 gingival recession defects: Reporting of two cases

Abstract

IntroductionOne of the most challenging aspects of treating gingival recession type 3 (RT3) is reconstructing lost interdental papillae, which is directly related to the loss of interproximal bone. Free gingival graft (FGG) has been successfully used to increase the keratinized tissue width (KTW) with minimal trauma to the interdental papilla. This presented case suggests that FGG can be used for reconstruction of lost initerdental papilla creeping attachment also plays an additional role in improving the results.Case PresentationThe included two case reports suggest a novel technique using an FGG that is shaped in an inverted T-shape to achieve partial root coverage, improve the compromised interdental papilla, and increase the KTW in RT3 defects.ConclusionsThis report presents a novel yet intuitive surgical technique for partial coverage of RT3 defects and reconstruction of the interdental papilla.SummaryThe inverted T-shape soft tissue graft may be a valuable technique for papillary reconstruction in the challenge of RT3 recessions.Key pointsWhy is this case new information?Reporting innovative technique with the interproximal extension of the FGG that sutured lingually with the lingual marginal gingiva.Improve interdental clinical attachment phenotype and height.More predictable root coverage because of increased vascularized interproximal bed for the graft to be survived.What are the keys to the successful management of this case?Having at least 2mm interproximal space for graft survival.Good Extension with proper fixation of the lingual part of the graft, and stabilization of the graft.What are the primary limitations to success in this case?limited capacity for perfusion and survival of the lingual extension due to limited vascularity.More investigations are necessary to confirm the validity of this technique.