Duration: 15 minutes, 57 seconds

Author: Dr. Egon Euwe

A Root Coverage Procedure with a Sub Epithelial CT Graft on a Patient with a High Smile Line

Imagine having a smile that you’re not confident about because of receding gums and an imbalance in your gingival levels. These dental issues can affect both the aesthetics and the health of your teeth. Fortunately, there are effective procedures available to address these problems and restore both the appearance and function of your smile. In this article, we will explore a root coverage procedure with a sub epithelial connective tissue (CT) graft on a patient with a high smile line.

Understanding the Patient’s Condition: Recessions and Gingival Level Imbalance

Before we delve into the details of the procedure, let’s first understand the condition of the patient. The patient in question experiences recessions, where the gum tissue pulls back from the teeth, exposing the roots. This can be caused by various factors, including gum disease, aggressive tooth brushing, and genetic predisposition. Additionally, there is an unbalance in the levels of the gingiva, the gum tissue surrounding the teeth. This can result in an uneven gum line, which can be a source of self-consciousness for the patient.

Variations in Tooth Shape: Rectangular and Triangular Incisors

Adding to the complexity of the case, the patient’s central incisors present with different shapes. One tooth is rectangular while the other is triangular. This dissimilarity in shape can further contribute to the irregular appearance of the smile. Thankfully, dental procedures can effectively address these issues and bring harmony to the overall look of the teeth.

The Root Coverage Procedure

To provide a comprehensive solution for the patient’s concerns, a root coverage procedure with a sub epithelial CT graft is recommended. This procedure involves several steps, each tailored to address specific aspects of the patient’s condition.

1. Flap Design

The first step in the procedure is flap design. The dentist carefully designs a flap, which is a small incision made in the gum tissue surrounding the affected tooth or teeth. This allows access to the underlying root surface and prepares the area for the subsequent steps of the procedure.

2. Partial Thickness Graft

Once the flap is created, a partial thickness graft is harvested from the patient’s palate. This graft contains connective tissue, which is rich in blood vessels and promotes the healing process. The graft is precisely placed over the exposed root surface, providing coverage and stability to the area.

3. Tetracycline Treatment

In some cases, the patient may have experienced root surface damage due to bacterial infection or decay. To ensure optimal healing and prevent further complications, a tetracycline treatment is incorporated into the procedure. Tetracycline is a powerful antibiotic that effectively targets and eliminates harmful bacteria, promoting healthier gums and preventing future infections.

4. Suturing

To secure the graft in place and facilitate proper healing, the dentist meticulously sutures the gum tissue back together. The sutures act as a support system, ensuring that the graft adheres to the underlying surface and promoting the growth of new tissue.

The Result: Proper Root Coverage and Improved Appearance

Following the root coverage procedure with a sub epithelial CT graft, the patient experiences a remarkable transformation. The exposed root surfaces are now covered, effectively addressing the issue of gum recession. Additionally, the gingival levels are balanced, resulting in a harmonious gum line that enhances the overall symmetry of the smile. The patient no longer has to worry about the negative impact of receding gums and can confidently share their enhanced smile with the world.


The root coverage procedure with a sub epithelial CT graft is a highly effective solution for patients with receding gums and an imbalance in gingival levels. By addressing both the aesthetic and health concerns associated with these issues, this procedure provides patients with restored confidence and a revitalized smile. If you are experiencing similar dental problems, consult with a qualified dentist to explore the best treatment options available to you.

Frequently Asked Questions

1. Is the root coverage procedure painful? No, the root coverage procedure is typically performed under local anesthesia, ensuring that the patient remains comfortable throughout the entire process. Any discomfort experienced post-procedure can be managed with over-the-counter pain medication. 2. How long does it take to recover from a root coverage procedure? The recovery time may vary from patient to patient. Generally, it takes about a week for the initial healing of the gum tissue. However, it may take several months for the graft to fully integrate and achieve optimal results. 3. Are there any risks associated with a sub epithelial CT graft? As with any surgical procedure, there are potential risks involved. However, complications associated with a sub epithelial CT graft are rare. Your dentist will discuss the risks and benefits with you before proceeding with the treatment. 4. How long do the results of a root coverage procedure last? The results can be long-lasting, especially with proper oral hygiene practices and regular dental check-ups. However, it’s important to note that individual factors such as genetics and lifestyle habits can influence the longevity of the results. 5. Can the root coverage procedure be combined with other dental treatments? Yes, depending on the specific needs of the patient, the root coverage procedure can be combined with other dental treatments such as tooth whitening, veneers, or orthodontic procedures. Your dentist will assess your case and recommend the best course of treatment for you.

Add comment