It is the aim of this article to present a case report involving the biopsy and subsequent histologic analysis of an acellular dermal matrix. The area of the graft in contact with the root surface did not demonstrate a histologic attachment, but was defined as fibrous tissue apposition to the root surface. In addition, the coronal portion of the graft did not appear to be revascularized or revitalized as would be expected with an autogenous soft tissue graft. Finally, no new cementum formation was seen, but displacement of the junctional epithelium was observed.

It is the aim of this article to present a surgical option to the traditional method of returning lost biologic width where invasion of the junctional and/or connective tissue attachment associated with a tooth has occurred. The alternative to conventional osseous resection involves reshaping the existing tooth surface in combination with conservative removal of the supporting alveolar bone to create the width needed for the restoration to be biologically acceptable. This procedure accomplishes several goals: (1) minimum supporting bone is removed; (2) deleterious root surface anatomy, such as grooves, concavities, and cementoenamel projections, is diminished; (3) a smooth root surface that is more biologically acceptable to soft tissue is created; (4) Class I and II furcation lesions may be decreased or eliminated; and (5) improved gingival contours and space for restorative materials can be created in situations in which close root proximity is present. This article will present a step-by-step approach to using root reshaping as an alternative to traditional crown lengthening.