# Customized Connective Tissue Graft Technique for Optimizing Interproximal Attachment Gain in Regenerative Treatment of Infrabony Defects: A Case Report With 36‐ to 56‐Month Follow‐Up

## TL;DR

This case report shows that a customized connective tissue graft technique can improve long-term soft tissue outcomes in regenerative treatment of gum defects.

## Contribution

A customized connective tissue graft technique is proposed for optimizing interproximal attachment gain in infrabony defect treatment.

## Key findings

- All three cases showed regenerative success with clinical attachment gain of ≥3 mm and probing depth ≤4 mm over 3–5 years.
- Case 1 showed complete resolution of buccal recession and increased papilla height.
- Case 3 demonstrated long-term improvement in interproximal gingival architecture.

## Abstract

The aim of this retrospective case report was to evaluate the long‐term effect of a customized connective tissue graft technique (c‐CTG) aimed at preserving or enhancing buccal and interproximal soft tissues in the context of regenerative treatment of infrabony defects in the esthetic zone.

Three patients presenting with a single, deep periodontal infrabony defect between the maxillary central incisors were treated using the c‐CTG. All sites demonstrated regenerative success, defined as a clinical attachment gain of ≥ 3 mm and probing depth ≤ 4 mm, maintained over a 3‐ to 5‐year follow‐up period. In Case 1, complete resolution of pre‐existing buccal recession was observed, along with a 2 mm increase in papilla height. Case 2 showed partial closure of a postoperative black triangle, with progressive papilla gain between 6 and 24 months. In Case 3, the initial interproximal gingival crater evolved into a positive soft tissue architecture that was maintained over the long term.

Based on the findings, the c‐CTG appears to be a feasible approach for achieving both predictable regenerative outcomes and long‐term enhancements in both buccal and interdental soft tissue contours.