Connective Tissue Graft with Coronally Advanced Flap at #13 and #14
Grafting

Chief Complaint
Patient presented for soft tissue surgery to address gingival recession at tooth #13 and #14.
Clinical Findings
Gingival recession noted on the buccal aspect of teeth #13 and #14. Adequate palatal donor site tissue available for connective tissue graft harvest.
Treatment Plan
Coronal advancement of gingiva at #13 and #14 using a subepithelial connective tissue graft harvested from the palatal site (teeth #14 to #17 region).
Pre-operative Assessment
Pre-op photos taken.
Surgical procedure explained to the patient.
Risks and possible complications discussed.
Quotation provided and consent obtained.
Patient agreed to proceed with the surgery.
Anesthesia
Local anesthesia administered via infiltration technique.
Surgical Procedure
Patient cleaned and draped.
Root and tooth surfaces of #13 and #14 disinfected using laser and cleaned with EDTA.
Sulcular incision made at #13 and #14.
Tunneling flap prepared on the buccal side from mid of #12 to mid of #15.
Connective tissue graft harvested from the palatal aspect, single incision from mesial of #14 to mid of #17.
15mm x 25mm autogenous CT graft dissected from keratinized gingiva and underlying periosteum.
Harvest site closed with 12 Surgipro monofilament polypropylene sutures.
CT graft trimmed and passed through the tunnel.
Graft secured in position under the buccal gingiva with sutures.
Buccal gingiva at #13 and #14 coronally advanced and sutured.
8 additional Surgipro sutures placed.
Hemostasis achieved.
Post-operative instructions provided.

Post-operative Assessment
Procedure completed without complications
Post-operative photos taken
Patient tolerated the procedure well

