الفهرس 
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Abstract
Localized ridge defects are frequently found in partially edentulous patients that impair the prosthetic restoration of the damaged ridge area causing aesthetic, phonetic and oral hygiene complications. These defects are associated with the deficit in the volume of bone and soft tissues within the alveolar process resulting from tooth extractions, external trauma and tumors. The extent of defect may include ;soft tissue, bone or combination . Topographical aberrations in the residual edentulous ridge often prevent the establishment of an ideal pontic-to-ridge relationship, and in such cases residual ridge augmentation surgery may be indicated.
Different surgical procedures are used for reconstruction of deformed, partially edentulous ridges. Grafting tissues and materials available for soft tissue augmentation are classified as autogenous, allograft, xenograft and alloplast. The classic procedures using autogenous soft tissue materials can be divided into 3 major groups:- free gingival grafts (FGG), subepithelial connective grafts (SCTG) and various types of roll and pedicle flaps.
The aim of this study was to compare of submucosal palatal island flap with subepithelial connective tissue graft in soft tissue augmentation in the maxillary esthetic zone. The keys to successful management of these cases are extending the palatal single incision to the defect site, prepare the pedicle graft longer than the actual dimensions of the defect, use caution when dissecting the pedicle at the curvature of the palate in the canine region to avoid fenestration of the palatal mucosa.
Twenty healthy participants with class I ridge defect according to Seibert classification were equally divided and randomly allocated to the study and the control groups. The study group patients received submucosal palatal island flap and the control group patients received free subepithelial connective tissue graft . Alginate impressions were taken presurgical and 3 months after surgery and poured into cast models . These casts were scanned and superimposed to determine the volume of soft tissue gained. linear measurements were taken from pre and 3 months post-operative casts using caliper. Pain, healing were also evaluated.
The results of our study revealed that there was greater volume gain with the subepithelial connective tissue graft in comparison to the submucosal palatal island flap 3 months after surgery. However, submucosal palatal island flap is less painful than subepithelial connective tissue graft. from our results we can conclude that submucosal palatal island flap is technique demanding and time consuming compared to subepithelial connective tissue graft.