Restoration of Non-Carious Cervical Lesions and Their Effect on Gingival Recession: A Systematic Review

Abstract

Non-carious cervical lesions (NCCLs) frequently coexist with gingival recession and may compromise
esthetics, comfort, plaque control, and periodontal stability. The periodontal implications of restoring NCCLs,
such as its influences on recession outcomes, remain uncertain. To evaluate whether restoring NCCLs influences
gingival recession and gingival health, and to explore whether different restorative materials lead to different
periodontal outcomes. This systematic review followed Preferred Reporting Items for Systematic Reviews
and Meta-Analyses 2020 guidance. Randomized clinical trials assessing NCCL restoration (alone or combined
with periodontal surgery) and reporting periodontal outcomes were included. Risk of bias was assessed using
Risk of Bias 2. Eight randomized clinical trials (2008–2021; 241 patients) were included. Materials evaluated
included resin composite/flowable resin, resin-modified glass ionomer cement, and giomer; several trials also
used root-coverage procedures, such as coronary advance flap with or without connective tissue graft. Mean
root coverage commonly ranged from 50% to 97% across groups. Across some of the studies, resin-based
restorations showed a positive trend in gingival health parameters, suggesting improved marginal conditions
and plaque control. However, changes in gingival recession itself were inconsistent, and material superiority
for recession reduction could not be established due to heterogeneity and incomplete outcome reporting in
some trials. Restoring NCCLs may support better local gingival health, but no restorative material consistently
improves gingival recession outcomes.