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Background One of the main objectives of periodontal reconstructive surgery is the coverage of exposed root surfaces. On some occasions, where caries, root resorption, or any form of restoration exists on the exposed root surface, the treatment planning becomes more complex. The aim of this study was to evaluate clinically the treatment of gingival recession defects associated with cervical lesions (CLs) by Resin Modified Glass Ionomer cement (RMGI) and Coronally Positioned Flap (CPF) at 6 months postsurgically. Method Twenty sites with buccal class I or II gingival recession, were assigned to one of the following groups: (Control group): Gingival recession without cervical lesion treated with coronally positioned flap only or (Test group): Gingival recession associated with cervical lesion treated with resin modified glass ionomer cement restoration followed by coronally positioned flap. The clinical measurements that were assessed and recorded at baseline, one, three and six months after the surgery included local plaque index (PI), local bleeding on probing (BOP), probing sulcus depth (PSD), keratinized tissue height (KTH), recession reduction (RR), clinical attachment level gain (CALG), percentage of relative root coverage (rRC), percentage of root coverage (RC), and percentage of restored root coverage (RRC). Results Intra- and intergroup analyses demonstrated no significant differences in PI, BOP, PSD, KTH, RR, CALG, rRC, RC, and RRC among the groups at any time. The mean RC score in control group was 83.33% ± 22.21%, mean RRC score in control group was 66.02% ± 21.87%, and mean rRC in control and test groups at 6 months post surgery were 15.36 % ± 5.28% and 18.01% ± 6.02% respectively. Conclusion Both treatments showed root coverage improvement without damage to periodontal tissues, supporting that the coronally positioned flap is a predictable treatment modality for both intact and restored root surfaces with resin modified glass ionomer cement over 6 – month period. [ABSTRACT FROM AUTHOR]