The purpose of this study is to compare four different connective tissue graft harvesting technique in terms of graft quality and patient post-operative morbidity

The primary aim is to compare 4 different connective tissue graft harvesting techniques in terms of morbidity and in terms of quality of the graft.

The secondary aim is to evaluate the outcome of gingival recessions treated with grafts obtained from different harvesting approaches, in terms of mean root coverage, complete root coverage, keratinized tissue gain, clinical attachment level gain and gingival thickness

Inclusion Criteria:

• 18 years of age or greater,
• Patients with no reported systemic diseases,
• Healthy periodontium or demonstrating stable periodontal condition following conventional periodontal therapy,
• Full mouth plaque score (FMPS) and full mouth bleeding score (FMBS) of < 15%,
• Clinical indication for periodontal plastic surgery utilizing CTG to treat either a single or a maximum of two recession defects (Miller class I, II) around natural teeth
• No history of previous palatal harvesting

Exclusion Criteria:

• Pregnancy
• Systemic condition that generally precludes surgical therapy or that could influence the outcome of therapy (e.g. Diabetes with HbA1c > 7%, INR > 3 etc.)
• Non-compensated systemic disease
• Poor oral hygiene with full mouth plaque score (FMPS) and full mouth bleeding score (FMBS) > 20% at baseline
• Inadequate endodontic treatment or tooth mobility at the site of surgery
• Radiographic evidence of bone loss