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

ABSTRACT Objective 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. Clinical Considerations 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. Conclusion 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.