Three patients with multiple Miller Class III recession defects with substantial bone loss were treated with hard tissue augmentation with the goal to prevent future recessions. The surgery involved a full-thickness mucoperiosteal coronally advanced flap, bone grafting, and primary flap closure. Freeze-dried bone allograft (FDBA) in combination with plasma rich in growth factors (PRGF) was grafted during the procedure. After more than 6 months, the treated sites showed soft tissue maturation and esthetic tissue blending. Clinically, an increase in convexity of alveolar ridge and soft tissue was observed, as well as a marked reduction in recession depth and gain in width of keratinized mucosa. Cone beam computed tomography showed a gain in buccal bone thickness. The use of FDBA in combination with PRGF appears to have potential for the treatment of Miller Class III defects by providing improved hard and soft tissue profiles.