Deep Margin Elevation

Six Lessons Approach Podcast by Dr. David Alleman

Why aren’t all dentists performing deep margin elevations with composite? It might be because you’re listening to old research. “Violating the biologic width” was disproven in 2014. Gingival tissue doesn't have an adverse reaction to the material, it has an adverse reaction to the biofilm under a retention crown or poorly bonded restoration. If you have experienced failures with glass ionomers, use composite instead. In 2019, 12-year clinical evaluations showed the success of composite, a material that better mimics a natural tooth compared to brittle glass ionomers. Understanding how to perform deep margin elevations is an essential tool for dentists wanting to save more teeth.

Article referenced in this episode:

• Dietschi D, Spreafico R. Current clinical concepts for adhesive cementation of tooth-colored posterior restorations. Pract Periodont Aesthet Dent 1998;10(1):47-5,
• Dietschi D, Et al. In vitro evaluation of marginal and internal adaptation after occlusal stressing of indirect class II composite restorations with different resinous bases. Ea J Oral Sci. 2003(111):73-80
• Magne P, Spreafico R. Deep margin elevation: a paradigm shift. Am J Esth Dent. 2012(2)86-96.
• 2014 proximal box elevation with resin composite and the dogma of biological width clinical r2-techinique and critical review
• Bresser RA, Et al. Up to 12 years clinical evaluation of 197 partial indirect restorations with deep margin elevation in the posterior region. J Dent. 2019.
• Dietschi, Spreafico. Adhesive Metal-Free Restorations. Quintessence Books; 1997.

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