Not all soft tissue defects are the same. When adequate KT is present, an autogenous graft is not always needed. In this recession case (Picture 1), #4 and 5 were treated with Dali Dermal Allograft and #6 was treated with an autogenous connective tissue graft (Pictures 2 & 3). 9 months later, we see root coverage with natural contours, thickness, and tone (Picture 4).
Excellent work. Could you have achieved the same outcome with more minimally invasive technique such as tunneling ? Could not resist the urge to ask.
Nice outcome. I’m not sure a tunneling procedure is minimally invasive. In my hands tunneling generally takes longer and I’m never totally happy with the immediate result. With a flap I am able to clean the roots and reduce cervical abrasion defects more completely and secure the graft to the level of the CEJ or better with less hassle. I can also coronally reposition the flap higher on the tooth to cover all the graft and more. My preference is to use autogenous graft because it seems to give a better result and is less technique sensitive in that it is not even necessary to completely cover the graft tissue to achieve success.
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