The goal of this case report is to evaluate the effectiveness of gingival augmentation with an acellular dermal matrix. The acellular dermal matrix was placed on a periosteal bed. Clinically, the procedure did not result in an increase in the amount of keratinized tissue. There was an increase in the tissue bulk, but the importance of this increase is unknown. Histologic evaluation revealed that the acellular dermal matrix did not slough and was involved in healing. Based on this evaluation, the technique of placing an acellular dermal matrix on a periosteal bed does increase the bulk of tissue in the area. However, the procedure does not seem to be an effective method to increase the amount of keratinized tissue.