Non-Carious Cervical Lesions: Causes, Treatment and Relationship with Gum Recession

🔍 Non-Carious Cervical Lesions (NCCL)

• Non-Carious Cervical Lesions (NCCL) are tooth wear near the gumline, typically on the buccal surface, unrelated to cavities. These lesions are often associated with gum recession, which can lead to aesthetics concerns, sensitivity, and lesion progression.

  Patients often describe them as a "hole in the tooth near the gum" or a noticeable "step."

  Studies indicate that over 50% of gum recession cases are related to NCCL (Halim et al., 2025). Root exposure due to recession increases vulnerability to abrasion, erosion, and abfraction, forming a vicious cycle: recession causes wear, and wear promotes more recession.

  Main causes:

  • Abrasion: aggressive brushing, hard-bristle brushes, poor technique

  • Erosion: acidic diet, citrus drinks, reflux

  • Abfraction: excessive occlusal forces (bruxism) causing cervical microfractures

  When to restore?

  • Dentin hypersensitivity

  • Esthetic concern

  • Hygiene difficulty

  • Lesion progression

  Restorative materials: composite resin, resin-modified glass ionomer, bioceramics.

  Restoration limit: do not extend beyond the cementoenamel junction (CEJ); if unclear, end no more than 1 mm below the maximum root coverage (MRC) line (Zucchelli et al., 2011).

  Gum surgery is indicated when:

  • Recession is present

  • Aesthetic improvement or protection is required

  Techniques include connective tissue grafts, coronally advanced flap, or tunneling with collagen matrix.

  Ideal approach:

  1. Control etiological factors

  2. Well-planned, biologically respectful restoration

  3. Gum surgery if necessary

  Treating NCCL is treating both teeth and gums.

📚 Referências

CHANG, K. C. J. et al. Vestibular tunnel approach in restoring non‐carious cervical lesion gingival recessions with combination of bioceramics and collagen matrix: A case report with a 1‐year follow‐up. Clinical Advances in Periodontics, v. 13, n. 1, p. 56–61, 2022.

GOODACRE, C. J. et al. Noncarious cervical lesions: Morphology and progression, prevalence, etiology, pathophysiology, and clinical guidelines for restoration. Journal of Prosthodontics, v. 32, n. 2, p. e1-e18, 2022.

GRIPPO, J. O. et al. A literature review and hypothesis for the etiologies of cervical and root caries. Journal of Esthetic and Restorative Dentistry, v. 30, n. 3, p. 187-192, 2018.

HALIM, F. C. et al. Effectiveness of restorative materials on combined periodontal-restorative treatment of gingival recession with cervical lesion: A systematic review. Heliyon, v. 11, e42656, 2025.

ZUCCHELLI, G. et al. Non-Carious Cervical Lesions Associated With Gingival Recessions: A Decision-Making Process. Journal of Periodontology, v. 82, n. 12, p. 1713-1724, 2011.