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Global Translational Medicine Connective tissue harvest techniques

A B C

D E

F G

H I

Figure 5. Two-incision SCTG harvest for root coverage at teeth #26 through #30. (A) Baseline clinical appearance of the hard palate. The patient exhibited
an unusually large, ovoid maxillary arch form. (B) SCTG harvested using a two-incision technique. (C) Incision design. A vertical incision was placed at
the mesiobuccal line angle of tooth #32. (D) SCTG harvested. Dimensions were approximately 8 × 42 mm. (E, F) Graft stabilized in position. (G) Wound
closure. (H, I) Post-operative appearance at 10 months.
Abbreviation: SCTG: Subepithelial connective tissue graft.

interdigitates with the epithelial pegs, complete removal of that 1-year mean root coverage (MRC) percentages for
the epithelium is difficult without sacrificing a portion of DGG and SCTG were 94% and 89%, respectively. The
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the reticular layer. In contrast, assuming a primary access use of DGG also resulted in superior probing depth
flap thickness of approximately 1.5 mm, an SCTG 2 mm reduction and gains in clinical attachment and keratinized
in thickness obtained through SIT or MIT may consist tissue width. However, this analysis included only 10
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predominantly of tissue derived from the submucosa, studies, and intergroup differences in clinical parameters
with little contribution from the lamina propria and no were all within 1 mm. In contrast to the findings of this
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epithelial cells. 20,27 Indeed, a cadaver study demonstrated systematic review, Bakhishov et al. did not identify graft
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that palatal SCTGs harvested using a partial-thickness flap type (DGG vs. SCTG) as a statistically significant predictor
(MIT or SIT) include a higher proportion of adipose and of MRC percentage. Zangrando et al. compared clinical
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glandular tissue compared with DGGs. 20 and patient-reported outcomes following root coverage
The higher proportion of fibrous tissue found in DGGs procedures using DGG or SCTG harvested using a double-
may or may not translate into differences in clinical blade scalpel (DBS). No statistically significant differences
outcomes between the two graft types, with mixed results in clinical parameters were identified; however, the DBS
reported. A systematic review and meta-analysis found group experienced significantly more discomfort compared

Volume 4 Issue 1 (2025) 40 doi: 10.36922/gtm.4860