Spontaneous Growth Induced by a Biologically Oriented V Class Restoration (BOVR) Technique: A 3D Prospective Study

Background: The behavior of soft tissues following recession type 1 (RT1) and/or non-carious cervical lesions (NCCLs) treated with class V restorations is not well understood. These conditions cause both functional and esthetic issues. Recent studies show that increased cervical thickness can influence gingival tissue response. This suggests that restoration design has a key impact. This study aims to evaluate the effect of tooth shape modification on gingival tissue response and periodontal health with 3D analysis. Methods: Seven patients with buccal gingival recession and NCCL were selected, resulting in 50 treated teeth. Patients underwent class V buccal restorations using the BOVR technique. Three-dimensional evaluation through scanned dental impressions was performed at baseline and at T1 to monitor tissue profile changes in the buccal zenith sagittal plane. The average observation period was 4 months. Following the assessment, linear measurements were calculated according to standard planes. These measurements aimed to monitor transverse and axial tissue modifications. Probing depth, plaque index, and bleeding index were also recorded. Results: Increased tooth thickness led to tissue alteration. Greater composite thickness was significantly associated with an increase in tissue thickness (p ≤ 0.001) and gingival creeping (p ≤ 0.001) at the free gingival margin. Periodontal health remained unaffected, and 50% of the teeth required no additional surgical treatment due to satisfactory outcomes. Conclusions: Class V restorations that increase cervical thickness may promote soft tissue volume gain over a 4-month period without compromising periodontal health. A 4-month observation period is recommended before considering the surgical correction.