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The Perio-Resto Interface: In Vitro Comparison of Two Deep Margin Elevation Techniques on Surface Roughness, Marginal

Pablo Cores Ziskoven1, Dorothea Vogel1, Sven Schumann2

  • 1Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany.

Dentistry Journal
|March 27, 2026
PubMed
Summary

The R2 technique for deep margin elevation (DME) showed better marginal adaptation and fewer voids than the modified matrix technique (MMT), though MMT created smoother composite surfaces. Both techniques are feasible for restorative challenges.

Keywords:
deep margin elevationdentogingival complexperiodontologyproximal box elevationrestorative dentistrysupracrestal connective tissue attachment

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Area of Science:

  • Restorative Dentistry
  • Periodontology
  • Dental Materials

Background:

  • Deep subgingival carious lesions pose significant restorative and periodontal challenges.
  • Managing these lesions requires careful consideration of the supracrestal attachment (SA).
  • Deep margin elevation (DME) techniques are employed to address these challenges.

Purpose of the Study:

  • To compare the modified matrix technique (MMT) and the R2 technique (R2T) for DME.
  • To evaluate surface roughness, marginal adaptation, surface integrity, voids, and excess adhesive material.
  • To determine technique-specific advantages in managing deep subgingival proximal carious lesions.

Main Methods:

  • Forty extracted human mandibular molars with standardized proximal cavities were used.
  • Cavities were prepared 2-3 mm below the cementoenamel junction (CEJ).
  • Teeth were randomly assigned to MMT or R2T groups, with flowable bulk-fill composite applied.

Main Results:

  • The modified matrix technique (MMT) yielded significantly smoother composite surfaces.
  • The R2 technique (R2T) demonstrated significantly fewer voids and better marginal adaptation.
  • No significant difference in surface integrity was found; R2T showed less excess bonding material.

Conclusions:

  • The R2 technique offers superior marginal quality with fewer voids and less excess adhesive material.
  • The modified matrix technique produces smoother composite surfaces.
  • Both DME techniques are feasible, with clinical choice dependent on anatomical and operator factors.