The purpose of this review was to evaluate the periodontal and peri-implant tissue responses to restorative approaches with and without a cervical finish line on teeth and dental implants. An electronic search was performed in PubMed/MEDLINE, Embase, Cochrane Library, LILACS, Web of Science, and Scopus databases and in the gray literature. Controlled clinical trials and prospective cohort studies were included. Analyzed outcomes included Gingival Index (GI), bleeding on probing (BOP), probing depth (PD), gingival thickness (GT), marginal stability (MS), and marginal bone loss (MBL). A meta-analysis was then performed in two parts: The first compared the results of restorations on teeth with and without a cervical finish line, and the second compared results of restorations on implant abutments with and without a cervical finish line. Regarding the tooth-based restoration analysis, 7 out of 1,388 selected articles were included in the systematic review, 2 of which were selected for the meta-analysis. For implant-based restorations on abutments with and without a cervical finish line, 6 out of 707 selected articles were included in the systematic review, with 3 included in the meta-analysis. No significant differences in periodontal and peri-implant indices were identified between either prosthetic approach in situations with and without cervical finish lines.