Abstract: Soft tissue defects frequently remain following epulis excision, which may lead to complications such as loss of interdental papillae, gingival recession, and root surface exposure. Conventional repair approaches are often associated with limitations including delayed revascularization and suboptimal morphological reconstruction, representing a clinical challenge. This article reported a case of fibrous epulis accompanied by stage Ⅲ grade B chronic periodontitis. After completion of initial periodontal therapy, a vascularized interpositional periosteal-connective tissue (VIP-CT) flap was utilized for simultaneous repair of the soft tissue defect following complete excision of the lesion. Postoperative follow-up revealed primary wound healing without evidence of infection or flap necrosis. The surgical site exhibited natural soft tissue contour and texture, harmonious color integration with adjacent mucosa, and stable root coverage outcomes. Effective reconstruction of palatal soft tissue morphology and periodontal health was achieved. This case demonstrates that the VIP-CT flap provides a reliable clinical option for the management of soft tissue defects subsequent to epulis excision.

Key words: Epulis, Vascularized interpositional periosteal-connective tissue flap, Pedicled connective tissue graft, Soft tissue defect, Gingival repair