A Patchwork SCTG For Papilla Reconstruction And Soft Tissue Augmentation.

Interdental papilla reconstruction is one of the most challenging clinical procedures in periodontal plastic surgery, and becomes even more difficult when addressing soft tissue defects and papilla loss following epulis resection, The author propose the effects of a new patchwork SCTG graft in the treatment of gingival papilla defects after epulis resection. An epulis case involving teeth #13-23 in the esthetic zone, with resultant wide irregular soft tissue defects and missing papilla between #11-21 after resection. A customized connective tissue graft was employed for reconstruction. During surgery, a properly sized connective tissue graft was harvested from the palate. Through extracorporeal trimming and suturing, the graft was contoured to match the defect morphology, then secured to the recipient site using an envelope flap technique. This approach successfully achieved both soft tissue defect repair and papilla reconstruction. During the 4-year follow-up period, the patient underwent orthodontic treatment and esthetic restoration of the maxillary anterior teeth. The soft tissue contour and interdental papilla morphology in the surgical area remained stable throughout the observation period. The patient expressed satisfaction with the treatment outcomes. While a patchwork SCTG offers unmatched versatility for reconstructing complex soft tissue defects, its successful application remains technique-sensitive and operator-dependent, requiring advanced microsurgical proficiency in periodontal plastic surgery. A patchwork SCTG transposition may produce ideal esthetic results in the treatment of gingival papilla defects after epulis resection.