These results prove that this new CM was as effective and predictable as the CTG for attaining a band of keratinized tissue, but its use was associated with a significantly lower patient morbidity.

Although these results are not conclusive, mostly due to a lack of a large enough sample population, the statistically significant results shown in this investigation tend to support the use of gingival augmentation procedures in prosthetic patients with insufficient keratinized gingiva and/or shallow or absent vestibules, when they cannot demonstrate adequate plaque control.

Both therapies led to short-term improvement of the measured parameters; neither was superior to the other.

Both therapies led to significant short- and long-term improvements in the outcome variables assessed.

Introduction:The case presented demonstrates a soft tissue volume augmentation procedure using a transflap ("buttonhole") incision, placed at the mucogingival junction (MGJ), to facilitate the passive advancement of a buccal flap without coronal transposition of the MGJ or reduction of vestibular depth.Case Presentation: The initial incision was placed crestal and slightly palatal in the area to be augmented. Vertical releasing incisions were placed to facilitate coronal advancement of the flap. Then, a subepithelial connective tissue graft was harvested from the palate and secured in the area to be augmented. A horizontal periosteal releasing incision was placed at the base of the flap to accomplish tension-free coronal advancement of the entire flap and sutured at the incision line. A "through-and-through" incision was drawn at the MGJ. At the level of the "buttonhole" opening, the graft was left exposed. The patient healed uneventfully with increased soft tissue thickness and without coronal displacement of the MGJ or shortening of the vestibular depth.Conclusions: This case report describes a new variation of the periodontal plastic surgery technique. It offers considerable advantages over previous modalities, using tools that are already in the surgical armamentarium of the periodontist, without increased treatment time or patient morbidity. Clin Adv Periodontics 2015;5:124-130.