Deep Margin Elevation: A Modern Practice to Succeed Posterior Adhesive Restorations

Zeineb Riahi*, Imen Kalghoum, Emna Boudabous, Zohra Nouira, Belhassen Harzallah, Mounir Cherif and Dalenda Hadyaoui
Department of Fixed Prosthodontics, University of Monastir, Tunisia
*Corresponding Author: Zeineb Riahi, Department of Fixed Prosthodontics, University of Monastir, Tunisia.

Published: July 14, 2023

DOI: 10.55162/MCMS.05.147

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Abstract  

Minimally invasive dentistry and adhesive dental restorations have changed the therapeutic options to restore posterior molars. Nowadays, to avoid useless teeth preparations and respond to the increasing aesthetic demands, the indication of resin or ceramic inlays and onlays is rising. However, the indication of this kind of restorations is restricted to small supragingival cavities. Therefore a severe decay or substance loss causing subgingival margins may be a real challenge to practitioners [2].

Elderton (1988) and Simonsen (1991) described the restorative cycle of death of the tooth. A tooth restoration fail leads to a larger restoration to restore the first defect, which leads itself to a bigger restoration and even an eventual root canal treatment. Thus, to avoid this restorative circle that may even lead to tooth loss, minimally invasive procedures must be considered to minimize the tooth substance loss and maintain pulp vitality. The most described indirect minimally invasive restorations are then ceramic or resin inlays and onlays [7].

However, cavities with deep cervical margins raise the issue of biological width, practitioners classically solve this problem by crown lengthening, either surgically or orthodontically [14].

To make the clinical procedures simpler and less fault-prone, Dietschi and Spreafico in 1998 introduced a technique named “cervical margin relocation”.

This concept suggests the application of a layer of composite in the deepest parts of the proximal areas in order to relocate the cervical margin supragingivally [11].