Why is this case new information? To the best of our knowledge, this is the first case report in the literature with a histological evaluation in a human of the tissue grafted exposed after 2 years. What are the keys to successful management of this case? The graft covered by the alveolar mucosa did not induce keratinization of the epithelium of the overlying mucosa. What are the primary limitations to success in this case? The main limitation of this study is that it is a singular case report.