Defects associated with severe interdental hard and soft tissue loss are challenging to the periodontist, mainly due to the increased avascular surface and the reduced interproximal periosteal bed. Reports on the surgical techniques used to address recession type 2 or 3 defects mostly showed statistics on the mid-facial root coverage that yielded outcomes that do not encompass coverage of the interdental exposed root surface which highlights areas of controversy in their use for papilla reconstruction. Several case reports and clinical studies have shown encouraging results, but the long-term data are not available in the literature yet. The novel 3D tunneling (3DT) method achieved significant clinical improvement with long term stability in a recent case series. However, additional research is needed to validate 3DT for its routine clinical use. Moreover, the 3DT method achieved a decrease in the lingual recession depth which should be pointed out that the technique also addresses lingual recession.