Impact of partial restoration margin level in combination with connective tissue graft on the treatment of single RT1 gingival recessions associated with non-carious cervical lesions: a 1-year randomized parallel-group trial.

Objectives To assess whether the apical margin position of partial restorations (PRs) influences outcomes of coronally advanced flap (CAF) plus connective tissue graft (CTG) in single RT1 gingival recessions with Class B+ non-carious cervical lesions (NCCLs).Materials And Methods Forty patients were randomized to receive PRs completed at the estimated cementoenamel junction (CEJ-0) or 1 mm apical to it (CEJ-1), placed two weeks before CAF + CTG. Clinical parameters-including recession depth (RD), mean root coverage (mRC%), keratinized tissue height, and gingival thickness-and patient-reported outcomes (pain, discomfort, sensitivity, esthetics) were evaluated up to 12 months.Results Thirty-five patients completed follow-up. RD reduction and mRC% were similar (CEJ-0: 1.91 ± 0.91 mm, 83.3%; CEJ-1: 1.93 ± 0.78 mm, 81.6%). Esthetic scores assessed using the Modified Root Coverage Esthetic Score (MRCES) were comparable (8.63 vs. 8.38). Both groups showed increased gingival thickness, while CEJ-1 yielded lower early postoperative sensitivity and discomfort. Baseline RD predicted RD reduction (β = 0.568; p = 0.02).Conclusions PR margins at or 1 mm apical to the CEJ provided similar clinical and esthetic outcomes when combined with CAF + CTG. The CEJ-1 approach improved early patient comfort without compromising root coverage.Clinical Relevance Positioning the restoration margin 1 mm apical to the CEJ may enhance early postoperative comfort while maintaining comparable clinical and esthetic outcomes.