A connective tissue graft (CTG) is a periodontal surgical procedure in which a layer of subepithelial connective tissue is harvested from the patient’s palate and transplanted to a recipient site to correct gingival recession and increase the zone of keratinized gingiva.
Why It Matters
Gingival recession — the apical migration of the gingival margin below the cementoenamel junction — exposes root surfaces to mechanical trauma, temperature sensitivity, and an elevated risk of root caries. Left untreated, recession can deepen as the underlying alveolar bone gradually resorbs. A connective tissue graft addresses this by restoring the soft tissue architecture, protecting the periodontal ligament apparatus, and improving the esthetic appearance of the smile.
Common Indications
- Miller Class I and II recession defects where complete root coverage is predictable
- Thin gingival biotype susceptible to future recession
- Root sensitivity due to exposed cementum or dentin
- Inadequate width of attached, keratinized gingiva
- Pre-prosthetic soft tissue augmentation before crown or veneer placement
How the Procedure Works
The surgeon prepares a split-thickness or partial-thickness recipient bed at the area of recession, then harvests a strip of dense connective tissue from beneath the palatal epithelium through a horizontal incision. The graft is carefully positioned over the exposed root surface and secured with resorbable sutures. Because the underlying periosteum and the overlying flap both contribute blood supply, graft survival rates are consistently high.
Over several weeks of healing, the transplanted tissue integrates with the recipient site, the exposed root becomes covered, and the band of keratinized gingiva widens — outcomes supported by decades of controlled clinical research.
Patients experiencing recession-related sensitivity or esthetic concerns should seek a periodontal evaluation promptly, as the predictability of complete root coverage diminishes once significant alveolar bone loss has occurred.