Background - Guided bone regeneration is a reliable and effective method in augmenting osseous defects.But the management of ensuing gingival recession in grafted teeth is still a challenge.Eventhough, various surgical techniques are available for recession coverage, a reliable technique in a grafted site is still perplexing. Methods –This case report describes management of periodontally compromised tooth with questionable prognosis in a 28 year systemically healthy male patient.Patient reported with functional and esthetic concern of maxillary central incisor, which is managed by guided bone regeneration and modified vascularised interpositional periosteal connective tissue graft (VIP -CT) with papilla preservation flap. Conclusion- The use of modified vascularised interpositional periosteal connective tissue graft (VIP -CT) with papilla preservation flap has resulted in significant gain in clinical attachment level and tissue volume. Therefore, this technique could be considered as a valid option for management of recession coverage in a grafted tooth.