Root Coverage Procedure With Connective Tissue Graft Harvested From a Distal Wedge: A Case Report

This case report illustrates the use of a connective tissue (CT) graft harvested from a distal wedge procedure for root coverage. The retromolar area could be an alternative donor site, especially when a distal wedge procedure is planned. This approach offers an alternative CT donor site for the treatment of a localized gingival recession (GR).

A healthy 22-year-old female patient presented with a localized Miller Class II GR defect on a mandibular incisor (tooth #25) caused by trauma from a lip piercing. Probing depths of 6 mm were also noted bilaterally over the distal aspect of the mandibular second molars. A root coverage procedure was performed, together with a distal wedge procedure for pseudopocket reduction. A CT graft harvested from a distal wedge was used for the root coverage. Complete root coverage with stable follow-up was documented up to 2 years, 5 months. Tissue from a contralateral distal wedge was submitted for histologic evaluation. Histopathologic examination showed dense collagenous fibrous tissue with no inflammatory infiltrates.

Localized GR can be treated with a CT graft harvested from a distal wedge without significant inflammation. The mandibular retromolar area may serve as an alternative viable donor site in selected cases.