Fig. 2

Schematic illustration of the surgical technique: Gingival recession (GR) at the lower right first incisor (a). At the recipient site, the trapezoidal flap is initially dissected as mucosal flap and 2 mm apically to the bone crest as mucoperiosteal flap. Note the de-epithelialization of the anatomical papillae (b). The connective tissue graft with epithelial striation (CTG-ES) is harvested at the donor site in two steps. Firstly, the epithelial flap is elevated in anterior-posterior direction using a mucotome blade with a width of 6 mm. Secondly, the CTG-ES is dissected in posterior-anterior direction using a mucotome blade with a width of 8 mm (c). The ideal positioning of the CTG-ES in a cross sectional view: The most coronal part of the CTG-ES projects above the cemento-enamel junction (CEJ) by 2 mm. Note that only the CTG segment of the graft is covered by the trapezoidal flap (d). The CTG-ES is positioned at the recipient bed and fixed with resorbable sutures. Note the partial de-epithelialization of the ES mesially and distally to the GR defect (e). Situation at the end of the surgical procedure: The flap is coronally advanced and fixed with sling sutures at the papillae and interrupted sutures at the releasing incisions (f)