Epithelial inclusions following a bilaminar root coverage procedure with a subepithelial connective tissue graft: A histologic and clinical study

The aim of this study was to histologically examine any epithelial cell inclusions in submerged sub-epithelial connective tissue graft (SCTG) after clinical healing was achieved. A total of 16 patients with Miller Class I or II gingival recessions were consecutively treated with a bilaminar procedure. At 2 months after surgery, a gingival tissue specimen was harvested from all SCTG-treated sites and stained with hematoxylin-eosin. The histologic evaluation revealed connective tissue in active reorganization without epithelial cells in 14 of the 16 tissue specimens. In the remaining 2 specimens epithelial islands were observed deep in the connective tissue. In one case they developed in a solid cystic space, while in the second case they were strictly integrated in the lamina propria. Complete root coverage was obtained in 14 of the 16 treated defects, with a mean root coverage of 95.1% ± 14.2% at 12 months.