{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T05:50:42Z","timestamp":1781848242446,"version":"3.54.5"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Adv Periodontics"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n This case report describes the clinical application of the subperiosteal tunnel\u2010assisted graft (STAG) technique, a novel approach for peri\u2010implant phenotype modification and keratinized tissue augmentation. Although free gingival grafts remain the gold standard for increasing keratinized tissue width, their effectiveness may be compromised by postoperative graft shrinkage or partial graft loss, often resulting from limited vascular supply, inadequate adaptation to the recipient bed, and insufficient graft stability\u2014particularly in posterior regions or sites with shallow vestibules where surgical access and tension control are more challenging.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The STAG technique was developed to overcome these limitations through the creation of a subperiosteal tunnel that enables bilateral graft insertion and stabilization using lasso sutures at both ends of the graft. This approach facilitates simultaneous augmentation of keratinized tissue, vestibular depth, and soft tissue thickness while minimizing graft mobility and enhancing adaptation to the recipient site.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The presented cases demonstrated successful augmentation of keratinized mucosa and vestibular depth, along with increased peri\u2010implant mucosal thickness and stable soft tissue integration at the treated sites.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The STAG technique may provide a predictable approach for the management of complex peri\u2010implant mucogingival deficiencies and peri\u2010implant phenotype enhancement.<\/jats:p>\n <\/jats:sec>\n \n Key points<\/jats:title>\n \n \n \n Subperiosteal tunnel\u2010assisted graft (STAG) technique offers a predictable alternative to conventional free gingival grafts for peri\u2010implant mucosal augmentation.<\/jats:p>\n <\/jats:list-item>\n \n By maintaining close adaptation between the donor graft and recipient bed, the STAG approach enhances vascular integration and reduces the risk of graft contraction or failure.<\/jats:p>\n <\/jats:list-item>\n \n This method enables peri\u2010implant mucosa phenotype modification therapy, including mucosal thickness gain, keratinized mucosa gain, vestibular depth, and frenum pull elimination in a single procedure, optimizing both function and patient comfort.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Plain language summary<\/jats:title>\n The subperiosteal tunnel\u2010assisted graft (STAG) technique provides a predictable and effective alternative to conventional free gingival graft by enabling superior graft adaptation between the donor tissue and recipient bed.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/cap.70079","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:52:53Z","timestamp":1781844773000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Subperiosteal tunnel assisted graft (STAG) technique: Report of two cases"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0716-0616","authenticated-orcid":false,"given":"Seiko","family":"Min","sequence":"first","affiliation":[{"name":"Department of Periodontics and Dental Hygiene University of Texas Health Science Center at Houston Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"684","article-title":"Free transplantation of gingival propria","volume":"22","author":"Bj\u00f6rn A","year":"1963","journal-title":"Swed Dent J"},{"issue":"5","key":"e_1_2_8_3_1","first-page":"243","article-title":"Free gingival grafts","volume":"4","author":"Nabers JM","year":"1966","journal-title":"Periodontics"},{"issue":"1","key":"e_1_2_8_4_1","first-page":"65","article-title":"Root coverage using a free soft tissue autograft following citric acid application. 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