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Deep Margin Elevation: Next-Level Adhesive Dentistry to Avoid Surgical Crown Lengthening.

Markus B Blatz¹, Florin Eggmann²

¹Professor of Restorative Dentistry, Chair, Department of Preventive and Restorative Sciences, and Assistant Dean, Digital Innovation and Professional Development, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania.

Compendium of Continuing Education in Dentistry (Jamesburg, N.J. : 1995)

|October 18, 2023

Summary

Deep margin elevation (DME) offers a conservative alternative to surgical crown lengthening for subgingival defects. This technique uses direct restorations to move margins supragingivally, simplifying indirect restorations and maintaining periodontal health.

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Area of Science:

Dentistry
Periodontology
Restorative Dentistry

Background:

Surgical crown lengthening (SCL) is standard for subgingival defects encroaching on biologic width.
Adhesive dentistry offers alternatives to SCL, avoiding bone removal and open interproximal spaces.

Purpose of the Study:

To provide an overview of deep margin elevation (DME) as a restorative technique.
To highlight DME's potential to complement or replace SCL in select cases.

Main Methods:

DME involves using a direct restoration to reposition the cervical margin of posterior teeth supragingivally.
This technique is suitable for small subgingival defects.

Main Results:

Systematic reviews suggest DME restorations have favorable clinical outcomes and high success rates.
DME is compatible with periodontal health when performed meticulously.

Conclusions:

Deep margin elevation simplifies impression-making and bonding for indirect restorations like inlays and onlays.
Success relies on optimal isolation, matrix placement, bonding, buildup, and regular follow-up.