Preparation Prior to Coverage: A Biological Staging Concept for Predictable Root Coverage Using Amniotic Membrane.

Gingival recession presents a clinical challenge when keratinized tissue width is limited, even with adequate tissue thickness. This case report describes a staged, biologically driven approach to localized recession in relation to tooth 43. Keratinized tissue was first augmented using a freshly procured amniotic membrane, preserved in glycerol to maintain integrity and antimicrobial properties, treated with penicillin powder prior to surgery, and rinsed with sterile saline to ensure biocompatibility. After one month, a lateral pedicle graft was performed to cover the recession defect. Postoperative evaluation demonstrated a stable soft-tissue architecture with a satisfactory gingival contour. This case emphasizes the value of biologic recipient site preparation in enhancing the predictability and success of periodontal plastic surgery.