Objective: The objective of this study is to examine the behavior and volumetric changes of periodontal tissues in teeth with cervical non-carious lesions associated with gingival recession and treated with composite resin restorations using conventional and biologically oriented preparation techniques (BOPT) after 12 months of clinical service. Material and Methods: A prospective clinical study was conducted to compare the gingival changes following the treatment of non-carious cervical lesions using composite resin and the BOPT approach (test group) with those restoring only the NCCL with a conventional restoration with composite (control group). The pre-treatment and 12-month post-treatment records included the following variables: plaque index (PI), gingival index (GI), gingival recession, probing depth, intraoral scan, and digitally calculated gingival thickness. The pre- and post-treatment scan files were subjected to software analysis to compare the dimensional gingival changes that occurred following treatment in both groups. Results: A one-year follow-up revealed a coronal gingival migration of 0.38 ± 0.49 mm in the control group and 1.16 ± 0.73 mm in the BOPT group (P<0.001). Additionally, the change in gingival thickness was -0.16 ± 0.23 mm in the control teeth and 0.35 ± 0.15 mm in BOPT teeth (P< 0.001). The periodontal parameters evaluated at baseline were found to be comparable between the two groups. Following treatment by both techniques, the periodontal health status remained unaltered. Conclusions: The BOPT technique, associated with cervical composite restorations for non-carious lesions, produces a recovery of the gingival tissue. There was a significant coronal gingival migration, as well as a horizontal thickening of the gingiva around the cervical emergence of the restoration. The BOPT approach using composite resins to treat NNCL is a predictable technique that offers biological advantages to the surrounding gingiva and achieves gingival stability.