Connective Tissue Graft Surgery
What Is a Connective Tissue Graft?
Connective tissue graft surgery (CTG) is the transfer of subepithelial connective tissue taken from donor sites such as the palate or tuberosity to an area with gum recession. This tissue without an epithelial layer may aim for a result close to the natural gum colour in aesthetic anterior areas.
Unlike the free graft on the gum graft page, CTG carries the connective tissue layer; the surgical protocol and flap design differ.
Surgical Technique and Indications
It may be combined with a coronally advanced flap, tunnel technique or pouch method. In Miller Class I and II recessions, root coverage and increased gum thickness may be planned together. Thickening a thin biotype may support prognosis.
Donor-site morbidity may differ from a free graft; palatal healing may take a few weeks. A double-suture technique is used for graft stabilisation.
Technical Difference from Gum Graft
A free gingival graft includes epithelium and connective tissue and may be preferred especially for thickening. CTG transfers the connective tissue layer and may offer colour-match advantages in aesthetic areas.
The graft type is chosen according to recession class, bone level, patient aesthetic expectation and donor tissue quality.
Healing and Medication Plan
In the postoperative period, analgesics and, when needed, antibiotics may be used on clinician advice; antibiotics are not routine in every graft case. Mechanical cleaning is avoided in the graft area during the first week.
Donor-site sensitivity may be temporary. Final tissue maturation may take months; early colour changes may be seen.
Prognosis and Limits
Success depends on donor quality, surgical technique, smoking and patient compliance. Complete root coverage may not be possible in every case; recession may rarely recur.
Restorative treatment may be combined with root-surface coverage after grafting. Regular follow-up monitors graft-margin stability.
In aesthetic anterior areas, graft colour matures over time; tone differences may be seen early.
The tunnel technique may reduce graft visibility in aesthetic areas; flap design depends on the surgeon s experience.
After donor-site healing is complete, the final contour of the recipient graft area is assessed; early swelling can be normal.
Avoiding smoking after grafting may support healing.
Regular periodontal review is recommended to monitor graft-margin stability.