Root coverage and papilla reconstruction using autogenous osseous and connective tissue grafts.

Previous studies have reported that the distance from the interdental crest of bone to the apical portion of the contact of the two approximating teeth must be 5 mm or less to support a stable interdental papilla. The reconstruction of a stable, long-term papilla for esthetic purposes must therefore consider interdental bone reconstruction. Autogenous osseous graft material was harvested from the tuberosity and augmented with a subperiosteal connective tissue graft for papilla reconstruction between the maxillary central incisors. Flap design, osseous graft fixation with a screw, connective tissue placement, wound closure, and suturing techniques are presented. To enhance the final result, porcelain veneers were bonded to the approximating central incisors. This case report demonstrates a surgical procedure that has not been reported to date for papilla reconstruction to enhance periodontal esthetics.