Soft tissue augmentation plays a crucial role in enhancing aesthetics, managing gingival recession, establishing an adequate band of keratinized mucosa, and supporting both periodontal and implant therapy. Traditionally, autogenous grafts such as free gingival grafts (FGGs) and connective tissue grafts (CTG) have been considered the gold standard due to their predictable outcomes and long-term stability.

Adequate dimensions of keratinized tissue and mucosal thickness are essential for maintaining optimal plaque control, minimizing inflammation, and preserving soft tissue architecture, thereby contributing to both functional and aesthetic outcomes. Maintenance of healthy soft tissue architecture is therefore considered an essential prerequisite for the long-term preservation of both natural dentition and dental implants.

There are many surgical techniques that can use either FGG or CTG to manage soft tissue defects or recession around teeth and implants, but the success of those techniques depends on the proper decision making that allow selecting the most suitable technique. In this lecture I will provide a protocol for the management of soft tissue defects and point out the main similarities and differences between two main techniques used for augmenting soft tissue defects around both teeth and implants.