An area of deep, long-standing recession on a mandibular first premolar was treated for root coverage in a 40-year-old woman. The recession was 6.0 mm deep with a probing depth of 2.0 mm, and there was no attached gingiva. A thick (1.5-mm) free autogenous epithelium and connective tissue graft from the palate was placed to the cementoenamel junction of the tooth after instrumentation and tetracycline conditioning of the root surface. The tooth and facial soft tissues were removed in block section 10.5 months later. At the time of extraction, there had been a gain of 5.0 mm of root coverage, and there was 5.0 mm of keratinized gingiva on the facial aspect. The probing depth was 1 mm. Histologic measurement showed 4.4 mm of new attachment and 4.0 mm of new bone growth. The coronal extent of the new attachment and new bone were in an area previously exposed by recession.