Abstract: Objective: This article aims to explore the diagnostic rationale and clinical management strategies for RT3 gingival recession (GR) with concomitant gingival papilla deficiency. Diagnosis and treatment: The case invovled a young female patient presenting with RT3 recession and papilla deficiency in the right maxillary anterior region. Considering the challenge of achieving optimal aesthetic outcomes through conventional root coverage procedures, a connective tissue graft-based soft tissue surgery was designed and performed, simultaneously addressing both papilla reconstruction and root coverage. Results: Through a single surgical intervention, partial root coverage was achieved with significant improvement in black triangle morphology. The patient expressed satisfaction with both functional and esthetic outcomes. Conclusions: This case validates the potential for improving RT3 GR through gingival papilla reconstruction, demonstrating that coordinated soft tissue augmentation can partially overcome the limitations of conventional root coverage techniques in complex GR scenarios.

Key words: RT3 gingival recession, gingival papilla, connective tissue graft, gingival papilla reconstruction, root coverage