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The technique of tunneling connective graft has made it to recover defective vestibular volume, since it does not compromise aesthetics; it also gives the patient the function of the damaged area. Objective: The present study aims to report a case of tunneling with connective graft to increase peri-implant volume. Case Report: A 53-year-old female leucoderma sought a private clinic with complaint of pain, aesthetic dissatisfaction of element 11 and that had already had endodontic retreatment of the element in question and paraendodontic surgery, but without success. After performing the clinical examination and computed tomography, there was a paraendodontic lesion and little vestibular thickness and reabsorption of the cortical bone. In the planning, we opted for exodontic the element 11 and implant placement immediately. After healing, the need soft tissue grafting in the peri-implant region was observed to for vestibular volume increase. Final Considerations: it's corroborated that the technique of connective graft tunneling for soft vestibular soft tissue remodeling and new arrangement  are excellent reconstructive technique, since it does not allow relaxing incisions, making it impossible to have scars. Descriptors: Connective tissue; Dental Implant; Grafts. References Faverani LP, Fereira GR, Gaetti-Jardim EC, Okamoto R, Shinohara EH, Assuncao WG, Rangel Junior IR. Implantes osseointegrados: evolucao e sucesso. Salusvita. 2011;30(1):47-58. Serrilho RP, Tolentino LS, Frare JG, Souza Pinto GN. Enxerto de tecido mole como opcao para suprir defeitos peri-implantares. Relato de caso clinico. Rev Assoc Paul Cir Dent. 2015; 69(4):350-54. Thoma DS, Naenni N, Figuero E, Hammerle CHF, Schwarz F, Jung RE et al. Effects of soft tissue augmentation procedures on peri- implant health or disease: a systematic review and meta- analysis. Clin Oral Implants Res. 2018;29(Suppl 15):32-49.  Giannobile WV, Jung RE, Schwarz F; Groups of the 2nd Osteology Foundation Consensus Meeting. Evidence-based knowledge on the aesthetics and maintenance of peri-implant soft tissues: Osteology Foundation Consensus Report Part 1-Effects of soft tissue augmentation procedures on the maintenance of peri-implant soft tissue health. Clin Oral Implants Res. 2018;29(Suppl 15):7-10. Zuhr O, Rebele SF, Cheung SL, Hurzeler MB; Research Group on Oral Soft Tissue Biology and Wound Healing. Surgery without papilla incision: tunneling flap procedures in plastic periodontal and implant surgery. Periodontol 2000. 2018;77(1):123-49. Xavier I, Alves R. Enxerto de tecido conjuntivo tunelizado – a proposito de um caso clinico. Rev port estomatol med dent cir maxilofac. 2015;56(4):256-61. Fiorin LG, Novaes VCN, Rinaldi H, Gusman DJR, Araujo NJ, Almeida JM et al. Enxerto de tecido conjuntivo subepitelial tunelizado em area periimplantar deficiente em mucosa queratinizada. Arch Health Invest 2017;6 (Spec Iss 2):154.

Tunneling with conjunctival graft for volume increase peri-implant: case report