What is the preferred donor site for harvesting a subepithelial CONNECTIVE TISSUE graft?

Correct answer: C. The posterior hard palate, between the distal of the canine and the mesial of the first molar

• A. The tuberosity is a legitimate and high-quality source, but it yields a limited volume and is often not available in dentate patients — the lateral palate is the workhorse site, not the tuberosity alone.
• B. Tissue immediately behind the central incisors contains prominent RUGAE, whose irregular architecture makes a poor graft, and this area is generally avoided.
• C. CORRECT. The standard donor site is the LATERAL PALATE in the PREMOLAR region, between the distal aspect of the canine and the mesial of the first molar, harvested 2-3 mm apical to the gingival margin. This zone offers the greatest thickness of dense fibrous connective tissue with the least fatty and glandular content, and it is the region where the palatal vault gives the greatest distance from the GREATER PALATINE neurovascular bundle. The tuberosity is an excellent secondary site, providing very dense tissue.
• D. The anterior mandibular vestibule has thin, mobile, loosely organised submucosa entirely unsuitable for grafting, and harvesting there risks the mental nerve.

Note: Safety rule for palatal harvesting: the greater palatine artery emerges from the greater palatine foramen (near the second/third molar) and runs anteriorly in the lateral palate. Available graft length is dictated by palatal vault height — in a SHALLOW vault the bundle may sit only 7 mm from the gingival margin, so limit the apical extent accordingly and stay within about 2 mm of the CEJ superiorly.