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Use of a hybrid soft tissue autograft for gingival phenotype modification lingual to mandibular incisors
  1. Vikender Singh Yadav1,
  2. Kanika Makker1,
  3. Razia Haidrus1 and
  4. Renu Yadav2
  1. 1Division of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
  2. 2Department of Prosthodontics, Surendera Dental College and Research Institute, Sriganganagar, Rajasthan, India
  1. Correspondence to Dr Vikender Singh Yadav; vikenderyadav{at}


Presence of adequate dimensions of keratinized/attached gingiva (KT/AG) and gingival thickness (GT) is considered necessary to maintain optimal periodontal health and long-term stability of gingival margin. Gingival phenotype modification therapies to increase these two dimensions (GT and KT/AG) on the buccal aspect of teeth have been widely reported, but the literature on lingual gingival augmentation is scarce. The purpose of this paper is to report the outcomes of a case treated with an envelope flap combined with a hybrid soft tissue autograft (subepithelial connective tissue graft with an epithelial collar) for phenotype modification of gingiva lingual to mandibular incisors presenting with thin gingiva (<1 mm) and lack of AG in tooth # 31 and 42. At 12 months follow-up, a substantial gain in KT, AG and GT along with partial root coverage was achieved.

  • Dentistry and oral medicine
  • Mouth

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  • Contributors VSY conceived the case report idea, performed the surgery and drafted the manuscript. KM assisted in surgery, conceived the case report idea and critically revised the manuscript. RH documented the case pictures, recorded clinical parameters and critically revised the manuscript. RY led the writing, performed literature search and critically revised the manuscript. All authors are in agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.