Association Between Periodontal Morphology and Non-Carious Cervical Lesions (NCCL-PM)

Relationship Between Periodontal Morphology, Oral Habits, and Non-Carious Cervical Lesions: A Cross-Sectional Observational Study

This observational study aims to investigate the relationship between periodontal morphology, oral hygiene habits, and non-carious cervical lesions (NCCLs) in adults aged 18-65 years. The main questions it aims to answer are:

Is there an association between periodontal soft tissue characteristics and the presence of NCCLs? Are oral hygiene habits and parafunctional behaviors associated with NCCLs?

Participants will:

Complete a structured questionnaire about oral hygiene habits and oral behaviors Undergo a clinical periodontal examination including assessment of plaque index, gingival index, probing depth, gingival recession, keratinized tissue width, gingival phenotype, and NCCL presence on the maxillary first premolar tooth

Study Overview

• Status: Completed
• Conditions: Non Carious Cervical Lesion; Gingival Recessions
• Intervention / Treatment: Diagnostic test: Periodontal Examination and Oral Habit Assessment

Detailed Description

Periodontal morphology and oral hygiene behaviors may play an important role in the development of non-carious cervical lesions (NCCLs), which are characterized by the loss of dental hard tissue at the cervical region of the tooth without the presence of dental caries. NCCLs are considered multifactorial conditions associated with mechanical stress, toothbrushing habits, parafunctional behaviors, and periodontal soft tissue characteristics.

This cross-sectional observational study is designed to investigate the relationship between periodontal morphology, oral hygiene habits, and the presence of NCCLs in adults aged 18-65 years attending the Faculty of Dentistry of Necmettin Erbakan University. A total of 180 participants are planned to be included.

Clinical periodontal examination will be performed on the maxillary first premolar tooth. The evaluated parameters will include probing depth, gingival recession, clinical attachment level, keratinized tissue width, gingival phenotype, plaque index, gingival index, dentin hypersensitivity, and the presence of NCCLs. Tooth position and parafunctional habits associated with occlusal stress will also be recorded.

Participants will complete a structured questionnaire regarding demographic characteristics, oral hygiene practices, toothbrushing frequency and technique, toothbrush type, brushing force, and oral habits.

The primary objective of the study is to determine whether periodontal soft tissue characteristics and oral hygiene-related behaviors are associated with the presence of NCCLs. Statistical analyses will include descriptive statistics, group comparisons, and multivariable logistic regression analyses to identify factors independently associated with NCCLs.

• Study Type: Observational
• Enrollment (Actual): 180

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Bilecik
    • Bilecik, Bilecik, Turkey (Türkiye), 11100
      • Bilecik Seyh Edebali University Faculty of Dentistry

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Adult patients attending the Faculties of Dentistry at Necmettin Erbakan University and Bilecik Seyh Edebali University for routine dental examination or periodontal evaluation will be recruited for this observational study. Participants will be selected from individuals presenting to the university dental clinics during the study period. The study population consists of community-based dental patients undergoing routine clinical periodontal assessment and questionnaire-based oral health evaluation.

Description

Inclusion Criteria:

• Adults aged between 18 and 65 years
• Presence of the maxillary first premolar tooth in the oral cavity
• Presence of at least 20 natural teeth
• Periodontally stable individuals without generalized active periodontal destruction
• Systemically healthy individuals or individuals with controlled systemic diseases
• Individuals who voluntarily agree to participate and provide informed consent

Exclusion Criteria:

• Presence of extensive restoration, caries, endodontic treatment, cervical restoration, crown/bridge restoration, orthodontic brackets, or retainers on the maxillary first premolar tooth
• Missing posterior teeth or edentulous posterior segments
• Ongoing orthodontic treatment
• Severe bruxism or use of occlusal splints/night guards
• Gastroesophageal reflux disease or bulimia nervosa
• Frequent acidic beverage consumption
• Smoking ≥5 cigarettes per day
• Pregnancy or lactation
• Individuals unable to comply with the clinical examination procedures

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
NCCL Present; Participants presenting with non-carious cervical lesions on the maxillary first premolar tooth during clinical examination.	Diagnostic test: Periodontal Examination and Oral Habit Assessment; Clinical periodontal examination and questionnaire-based assessment will be performed to evaluate periodontal morphology, oral hygiene habits, and the presence of non-carious cervical lesions (NCCLs). Clinical parameters including probing depth, gingival recession, clinical attachment level, keratinized tissue width, gingival phenotype, plaque index, gingival index, dentin hypersensitivity, and tooth position will be recorded on the maxillary first premolar tooth. Participants will also complete a structured questionnaire regarding oral hygiene behaviors, toothbrushing habits, and parafunctional activities.
NCCL Absent; Participants without non-carious cervical lesions on the maxillary first premolar tooth during clinical examination.	Diagnostic test: Periodontal Examination and Oral Habit Assessment; Clinical periodontal examination and questionnaire-based assessment will be performed to evaluate periodontal morphology, oral hygiene habits, and the presence of non-carious cervical lesions (NCCLs). Clinical parameters including probing depth, gingival recession, clinical attachment level, keratinized tissue width, gingival phenotype, plaque index, gingival index, dentin hypersensitivity, and tooth position will be recorded on the maxillary first premolar tooth. Participants will also complete a structured questionnaire regarding oral hygiene behaviors, toothbrushing habits, and parafunctional activities.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Presence of Non-Carious Cervical Lesions	The presence or absence of non-carious cervical lesions on the maxillary first premolar tooth will be assessed by clinical examination. NCCL will be recorded as a binary outcome: present or absent.	At baseline / single clinical examination

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Keratinized Tissue Width	Keratinized tissue width will be measured in millimeters from the free gingival margin to the mucogingival junction at the mid-buccal aspect of the maxillary first premolar tooth.	At baseline / single clinical examination
Gingival Phenotype	Gingival phenotype will be evaluated using periodontal probe transparency and classified as thin or thick phenotype.	At baseline / single clinical examination
Oral Hygiene Habits	Oral hygiene habits including toothbrushing frequency, toothbrush type, brushing technique, and brushing force will be assessed using a structured questionnaire.	At baseline / single assessment

Collaborators and Investigators

• Sponsor: Bilecik Seyh Edebali Universitesi
• Collaborators: Necmettin Erbakan University

Study record dates

Study Major Dates

• Study Start (Actual): February 26, 2026
• Primary Completion (Actual): May 15, 2026
• Study Completion (Actual): May 15, 2026

Study Registration Dates

• First Submitted: June 1, 2026
• First Submitted That Met QC Criteria: June 1, 2026
• First Posted (Actual): June 5, 2026

Study Record Updates

• Last Update Posted (Actual): June 5, 2026
• Last Update Submitted That Met QC Criteria: June 1, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: non carious cervical lesion; periodontal morphology; oral hygiene habits
• Additional Relevant MeSH Terms: Periodontal Atrophy; Periodontal Diseases; Mouth Diseases; Stomatognathic Diseases; Gingival Diseases; Gingival Recession
• Other Study ID Numbers: 29759

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No