Customized Connective Tissue Graft Technique for Optimizing Interproximal Attachment Gain in Regenerative Treatment of Infrabony Defects: A Case Report With 36- to 56-Month Follow-Up.

OBJECTIVE

The aim of this retrospective case report was to evaluate the long-term effect of a customized connective tissue graft technique (c-CTG) aimed at preserving or enhancing buccal and interproximal soft tissues in the context of regenerative treatment of infrabony defects in the esthetic zone.

CLINICAL CONSIDERATIONS: Three patients presenting with a single, deep periodontal infrabony defect between the maxillary central incisors were treated using the c-CTG. All sites demonstrated regenerative success, defined as a clinical attachment gain of ≥ 3 mm and probing depth ≤ 4 mm, maintained over a 3- to 5-year follow-up period. In Case 1, complete resolution of pre-existing buccal recession was observed, along with a 2 mm increase in papilla height. Case 2 showed partial closure of a postoperative black triangle, with progressive papilla gain between 6 and 24 months. In Case 3, the initial interproximal gingival crater evolved into a positive soft tissue architecture that was maintained over the long term.

CONCLUSION

Based on the findings, the c-CTG appears to be a feasible approach for achieving both predictable regenerative outcomes and long-term enhancements in both buccal and interdental soft tissue contours.