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Review
. 2022 Oct 18;58(10):1482.
doi: 10.3390/medicina58101482.

Deep Margin Elevation: Current Concepts and Clinical Considerations: A Review

Majed Aldakheel  1 , Khalid Aldosary  1 , Shatha Alnafissah  2 , Rahaf Alaamer  2 , Anwar Alqahtani  2 , Nora Almuhtab  3
Affiliations
Review

Deep Margin Elevation: Current Concepts and Clinical Considerations: A Review

Majed Aldakheel et al. Medicina (Kaunas). .

Abstract

Dietschi and Spreafico first proposed deep margin elevation (DME) in 1998 to address the multiple clinical problems associated with sub-gingival margins, where sub-gingival margins will be repositioned coronally using composite resin restorations. Given that dentistry is directing towards conservatism, its use is currently trending.

Materials and methods: a search was performed through PubMed, Scopus, and Google Scholar search engines to obtain relevant articles with no time restriction.

Results: With biological width taken into consideration, well-defined and polished sub-gingival restorations are compatible with periodontal health. Marginal integrity in the DME technique seems to be affected by the type of adhesive, restoration, and incremental layering of the restoration. Regarding fracture resistance, DME has no significant effects.

Conclusion: The DME technique seems to be a minimally invasive alternative to surgical crown lengthening (SCL) and orthodontic extrusion (OE) with respect to biological width. Well-controlled clinical trials are limited in this field; further long-term follow-up studies emphasizing the periodontal outcomes and prevention of complications are needed.

Keywords: cervical margin relocation; deep margin elevation; proximal box elevation; sub-gingival margins.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the studies selection.
Figure 2
Figure 2
The deep margin elevation concept. (A) A layer of sub-gingival composite. (B) The final restoration.
See this image and copyright information in PMC

References

    1. Dietschi D., Spreafico R. Current Clinical Concepts for Adhesive Cementation of Tooth-Colored Posterior Restorations. Pract. Periodont. Aesthet. Dent. 1998;10:47–54. - PubMed
    1. Magne P., Spreafico R.C. Deep Margin Elevation: A Paradigm Shift. Am. J. Esthet. Dent. 2012;2:86–96.
    1. Juloski J., Köken S., Ferrari M. Cervical Margin Relocation in Indirect Adhesive Restorations: A Literature Review. J. Prosthodont. Res. 2018;62:273–280. doi: 10.1016/j.jpor.2017.09.005. - DOI - PubMed
    1. Binalrimal S.R., Banjar W.M., Alyousef S., Alawad M., Alawad G. Assessment of Knowledge, Attitude, and Practice Regarding Deep Margin Elevation (DME) Among Dental Practitioners in Riyadh, Saudi Arabia. Fam. Med. Prim. Care Rev. 2021;10:1931. doi: 10.4103/jfmpc.jfmpc_1707_20. - DOI - PMC - PubMed
    1. Sarfati A., Tirlet G. Deep Margin Elevation Versus Crown Lengthening: Biologic Width Revisited. Int. J. Esthet. Dent. 2018;13:334–356. - PubMed

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