A novel technique utilizing a free gingival graft to treat a suprabony pocket distal to the mandibular second molar:...

To describe a novel free gingival graft (FGG) technique, the 'M-saddle FGG technique' for treating non-keratinized tissue distal to a mandibular second molar associated with a suprabony periodontal pocket, inflammation, and patient discomfort. A 30-year-old patient presented with persistent discomfort, bleeding, food impaction, a 6-mm suprabony periodontal pocket distal to tooth #3.7, 1 mm of keratinized tissue width (KTW), and reduced vestibular depth (VD). A modified horseshoe-shaped FGG was harvested from the palate and adapted over the distal crest and buccal periosteum. Outcomes were assessed after 3 months. At 3 months, discomfort, inflammation, and soft tissue trauma during function were completely resolved. KTW and VD both increased by 4 mm, and periodontal probing depths reduced by 3 mm. The 'M-Saddle FGG technique' improved KTW, periodontal parameters, VD, and patient comfort, representing a promising novel treatment option for selected mandibular second molar mucogingival defects and suprabony periodontal pockets.