A Comparative Evaluation of Fiber-Reinforced Composite and Conventional Composite Restorations in Non-Carious Cervical Lesions: A Randomized Clinical Trial

Abstract Background: Non-carious cervical lesions (NCCLs) pose a clinical challenge due to their multifactorial etiology and unique biomechanical demands. Fiber-reinforced composites (FRCs) offer enhanced mechanical properties, potentially improving the longevity of restorations in NCCLs. This study compares the clinical efficacy of FRCs and conventional composites (CCs) in NCCLs across two age groups (<50 years and >50 years). Aim: To evaluate and compare the clinical efficacy of FRC and CC restorations in NCCLs across two age groups, with a focus on assessing restoration retention, marginal adaptation, anatomic form, and post-operative sensitivity over the 12-month follow-up period. Methods: This randomized clinical study included 132 NCCLs in 44 patients and divided into three groups: Group X (CC), Group Y (CC + flowable liner), and Group Z (FRC using a biomimetic approach). Restorations were performed following standardized protocols. Clinical performance was evaluated at six and 12 months using the modified United States Public Health Service criteria, assessing retention, marginal adaptation, anatomic form, surface texture, secondary caries, and post-operative sensitivity. McNemar and Mann–Whitney U tests with statistical significance set at P < 0.05 were applied for statistical analysis of data. Results: No significant differences were observed in most parameters across the protocols at six and 12 months. However, Group X showed significant deterioration in anatomic form ( P = 0.027, CI: 0.72–0.95) in the <50-year group at 12 months. Group Z demonstrated superior marginal adaptation and minimal discoloration compared with Group X in the >50-year group, though these differences were not statistically significant. Conclusion: FRC restorations exhibit comparable performance to CCs in NCCLs over 12 months, with potential advantages in younger populations. Future studies should evaluate long-term outcomes and assess biomimetic protocol impact on restoration longevity in NCCLs. Clinical Trials Registry No . -CTRI/2024/01/061765.