International Journal of Clinical Case Reports 2017, Vol.7, No.2, 4-8
8
procedures performed by Raetzke (Raetzke, 1985). Nelson performed root coverage of areas with extreme
gingival recession using sub-epithelial connective tissue grafts where he found an average 88% of root coverage
(Nelson, 1987).The comparative analysis of root coverage achieved by Jahnke et al compared the use of gingival
grafts and connective tissue grafts in the same patient and found that the amount of coverage and rate of complete
coverage to be better with the use of connective tissue grafts (Jahnke et al., 1993). Hence, due to high success rate
of connective tissue grafts, it is usually preferred over other procedures for root coverage. Also, the donor site is
covered by a partial thickness flap leading to comparatively less post-operative pain and associated co-morbidities.
Also, the placement of connective tissue graft within the pouch maintains its vascularity and graft survival
becomes easier with successful outcomes.
4
Conclusion
The choice of surgical technique depends upon the advantages and disadvantages of different procedures. The
failure to determine a 3- dimensional (3-D) vertical bony defect and placement of incision closer to defect might
have resulted in the negative outcome attained with the modified Whale’s tail technique with DFDBA graft in the
present case. Connective tissue graft (CTG) used to overcome this failure led to achievement of satisfying clinical
results. The pouch creation technique resulted in quick healing along with better esthetics obtained due to its
minimal invasive approach.
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