Inverted T-Shape Connective Tissue Graft for Interdental Papilla Reconstruction: A Clinical Case Series

Area of Science:

• Periodontology
• Oral and Maxillofacial Surgery
• Regenerative Dentistry

Background:

• Interdental papilla loss in advanced gingival recession poses esthetic and functional challenges.
• Traditional methods for papilla reconstruction may be limited by vascularity and access.
• The inverted T-shape connective tissue graft (IT-CTG) technique offers a novel surgical approach.

Purpose of the Study:

• To evaluate the clinical application and outcomes of the IT-CTG technique for interdental papilla reconstruction.
• To assess both quantitative and qualitative results in a consecutive case series of patients with advanced gingival recession.

Main Methods:

• The IT-CTG technique utilized a remotely mucoperiosteal tunnel approach with a palate-harvested graft.
• Five patients with RT2 or RT3 recession and papilla loss were included.
• Outcomes measured included papilla height gain and Jemt's papilla index at 3, 6, and 12 months.

Main Results:

• Complete papilla fill (Jemt index score 2) was achieved in 40% of sites (RT3 cases).
• Partial fill (Jemt index score 1-2) was observed in 60% of sites (RT2 cases).
• Mean Jemt's papilla index improved from 0.2 to 1.8, with acceptable esthetics and minimal morbidity.

Conclusions:

• The IT-CTG technique demonstrated acceptable papilla reconstruction and esthetic outcomes with minimal complications.
• Further controlled studies with larger sample sizes are needed to confirm efficacy.
• Adjunctive restorative procedures may enhance papilla fill and long-term stability.