Fig. 1

Gingival recession (GR) at the lower right first incisor (a). Note the lack of keratinized tissue illustrated by a periodontal probe and the rolling technique (b) and the bone dehiscence after preparation and mobilisation of the trapezoidal flap (c). The connective tissue graft with epithelial striation (CTG-ES) was harvested at the donor site using a mucotome and the modified trapdoor technique (d-k). The preparation of the epithelial pedicle flap was conducted with a mucotome blade with a width of 6 mm in anterior-posterior direction (e). The preparation of the CTG-ES was performed with a mucotome blade with a width of 8 mm in posterior-anterior direction (f). Note the ES adjacent to the marginal gingiva (h). CTG-ES fixed at the recipient site with resorbable sutures covering the bone dehiscence and the GR defect (l). Note the even and uniform thickness of the graft and the epithelial striation (ES) of about 2 mm width (l, window). Periosteal slitting at the mucogingival junction (m). Recipient site at the end of surgery (n) as well as 8 days (o), 6 months (p), and 13 years (q) after surgery