Flap surgery in conjunction with an autologous connective tissue graft
Miller class III recession type defects are characterized by mild interproximal hard and soft tissue loss. The interdental tissue is coronal to the buccal gingival margin and the recession extends beyond the mucogingival junction. Concerning treatment prognosis, complete root coverage is less predictable and determined by the level of the papilla height and the interproximal bone loss. Different treatment modalities may be required depending on the individual case. In a regenerative therapy, an autologous subepithelial connective tissue graft (CTG) (in conjunction with enamel matrix derivative) may be used to cover exposed roots. Alternatively, a collagen matrix (mucoderm®) may be applied. Although the application of mucoderm® in the treatment of Miller class III recessions has been reported with a positive outcome , results are typically less predictable compared to those obtained in Miller class I and II recessions.
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The harvesting site of a CTG can be covered with a collagen fleece (collafleece®) in order to control the bleeding and to support the wound healing process .
collafleece® is a pH-neutral, wet-stable fleece made of native collagen with a highly efficient hemostatic effect. The well-known effect of collagen is induced by the adhesion of platelets to the collagen fibrils. As a consequence, platelets aggregate and release coagulation factors by degranulation. This initiates the coagulation cascade that leads to hemostasis. collafleece® is completely resorbed by natural processes occuring in the body within two to four weeks.
 Cosgarea et al. Quintessence Int. 2016 Jul 21. [Epub ahead of print]
 Zirk et al. Oral Maxillofac Surg. 2016 Sep;20(3):249-54.