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A lateral sliding pedicle flap can be used to cover root surfaces denuded of gingiva. Adjacent areas must have adequate attached gingiva for flap development and movement. 1 The lateral sliding pedicle flap for gingival cleft repair at the maxillary canine tooth has been described in a previous step-by-step article in which the flap originated at the distal aspect of the cleft and was transposed mesially. 2 For gingival cleft defect of the mandibular canine tooth, a distally based flap may be more difficult to develop due to the presence of the frenulum. 3 Disruption of the frenulum and subsequent postoperative contraction of muscular tissue in the frenulum may jeopardize success of the procedure. Ultimately, tissue may be harvested in either direction for maxillary and mandibular canine tooth gingival cleft repair. It is the clinician's responsibility to determine which option will provide the best result. In some cases, it is advantageous to originate the flap from the mesial aspect of the cleft as described here step-by-step. Figure 1Oral photographs in a cadaver specimen (A) and clinical case (B) with a gingival cleft at the left mandibular canine tooth (304). Root planing is performed on the canine root surface and the area is lavaged with sterile saline. The teeth are scaled and polished prior to the procedure.

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