title: Subperiosteal connective tissue grafts for pocket reduction and preservation of gingival esthetics: a case report.
abstract: BACKGROUND
  Clinical studies and recent histological evidence following mucogingival surgery for the treatment of gingival recession have documented that when closely adapted to a previously exposed root surface, connective tissue is capable of forming a new attachment. Despite these findings, no clinical tests have been conducted to examine the ability of connective tissue to reduce probing depth (PD) and increase clinical attachment levels (CAL) when it is implanted into periodontal osseous defects. The purpose of this paper is to report the clinical results on a patient following 2 subperiosteal connective tissue grafts.
  
  
  METHODS
  Subperiosteal connective tissue grafts were placed in 2 sites of periodontal bone loss and deep pocketing in one patient. Following flap reflection and root preparation, a connective tissue graft 1.5 to 2.0 mm in thickness was draped and sutured over each osseous defect and then completely covered by the external flap.
  
  
  RESULTS
  Ten months following subperiosteal connective tissue grafting, tooth #7 had 4 mm of CAL gain. Tooth #10 had 3 mm of CAL gain 8 months postoperatively. Both teeth had 1 mm gain in gingival recession. Both teeth probed 3 mm postoperatively.
  
  
  CONCLUSIONS
  When connective tissue was grafted into 2 periodontal osseous defects, there were significant reductions in probing depth and gains in CAL. There was minimal postoperative gingival recession. The new clinical attachment gain remained stable for 8 to 10 months following subperiosteal connective tissue grafting.
authors.forename: S W
authors.initials: SW
authors.lastname: Nelson
mesh_terms: D016301:Alveolar Bone Loss / Q000601:surgery*; D003238:Connective Tissue / Q000637:transplantation*; D004955:Esthetics, Dental; D005260:Female; D005881:Gingiva / Q000637:transplantation; D005889:Gingival Recession / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D019647:Oral Surgical Procedures; D010514:Periodontal Pocket / Q000601:surgery*