Purpose: To evaluate whether a human dermis graft (HDG) could be used instead of an autogenous connective tissue graft (ACT) to increase gingival thickness and to cover multiple gingival recessions. Materials and methods: Forty-two consecutive patients with multiple gingival recessions were offered the option to have their recessions covered either with ACTs harvested from their palate or with HDGs. Outcome measures were complications, gingival recession changes (REC), gingival biotype changes (BIO), probing attachment level changes (PAL), probing pocket depth changes (PPD) and keratinised mucosa height changes (KER) evaluated by an independent and masked assessor after 6 months. Results: Twenty-one patients with 110 recessions opted for ACTs and 21 patients with 160 recessions opted for HDGs. No patients dropped out. Only one minor complication occurred at one HDG-treated site. Recessions significantly decreased in both groups (2.7 mm for ACT and 2.0 mm for HDG), however, ACTs resulted in a statistically significantly improved root coverage and CAL of 0.5 mm, as well as 18% more root coverage than HDGs. Conclusions: HDGs can be an effective alternative to ACTs for covering exposed roots and increasing soft tissue thickness, especially when many recessions have to be treated in the same mouth, though they may provide slightly less root coverage than ACTs. Keywords: aesthetic, connective tissue graft, gingival recession, preference controlled clinical trial, soft tissue augmentation