International Journal of Clinical Case Reports 2017, Vol.7, No.2, 4-8
4
Case Report Open Access
Connective Tissue Graft (CTG): A Saviour to Regain Smile Following
Complication of Modified Whale’s Tail Technique
Sachin S. Deshmukh
1
, Sandeep G. Patel
1
, Motilal R Jangid
1
, Ujjwala Makne Shelke
1
, Bhagyashree More
1
, Sandhya Rathod
Chavan
1
, Abhishek Singh Nayyar
2
1 Department of Periodontology and Oral Implantology, Saraswati-Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani,
Maharashtra, India
2 Department of Oral Medicine and Radiology, Saraswati-Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani,
Maharashtra, India
Corresponding author e-mail
International Journal of Clinical Case Reports 2017, Vol.7, No.2 doi
Received: 21 Mar., 2017
Accepted: 24 Apr., 2017
Published: 05 May, 2017
Copyright © 2017
Deshmukh et al., This is an open access article published under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article:
Deshmukh S.S., Patel S.G., Jangid M.R., Shelke U.M., More B., Chavan S.R., and Nayyar A.S., 2017, Connective Tissue Graft (CTG): A saviour to regain
smile following complication of modified Whale’s tail technique, International Journal of Clinical Case Reports, 7(2): 4-8 (doi:
Abstract
The etiology of gingival recession is multi-factorial while the treatment of gingival recession is based on the assessment
of etiological factors and the amount of tissue involved. Modified Whale’s tail technique can be used to access the intra-bony defect
following the placement of the required graft to achieve closure of the defect. The purpose of this case report is to describe the
complication following modified Whale’s tail technique to achieve primary closure and thereby, leading to gingival recession in
relation to right central incisor and its management with connective tissue graft (CTG) by creating a pouch in the interdental region
of maxillary central incisors.
Keywords
Connective Tissue Graft (CTG); Gingival recession; Modified Whale’s Tail Technique
Background
The purpose of this case report is to describe the complication following modified Whale’s tail technique to
achieve primary closure and thereby, leading to gingival recession in relation to right central incisor and its
management with connective tissue graft (CTG) by creating a pouch in the interdental region of maxillary central
incisors. This case study includes the newer treatment modality used to access the vertical bony defect in the
interdental region of maxillary central incisors. Modified Whale’s tail technique was used to access the intra-bony
defect following which DFDBA graft was placed. This technique failed to show proper healing leading to
recession along the incision margin of right central incisor. Connective tissue graft was placed by creating a pouch
beyond the mucogingival junction for root coverage. Recently, a new surgical technique the “Whale’s tail”
technique was described to regenerate wide intra-bony defects in the anterior region where esthetic is the prime
concern (Bianchi and Bassetti, 2009). The incisions were placed in such a manner that a large buccal flap was
elevated with its base attached to the palatal side for access to intra-bony defect in interdental area. Such type of
flap was created to perform guided tissue regeneration (GTR) while preserving the interdental tissues over the
graft material.
1 Gingival Recession
Gingival recession is defined as the exposure of root surface resulting from the migration of the gingival margin
apical to the cementoenamel junction (CEJ). It can be seen in association with one or, more teeth and may be
localized or, generalized (Kassab and Cohen, 2003).
The etiology of gingival recession is:
Plaque- induce inflammation;
Calculus and iatrogenic restorations;
Improper oral hygiene practice causing trauma;
