Deep Margin Elevation: A Paradigm Shift

Localized subgingival margins can complicate the use of indirect adhesive restorations (isolation, impression taking, and delivery) and subsequently hinder their durability and relationship with the periodontal tissues. This article proposes a technique involving placement of a modified Tofflemire matrix followed by immediate dentin sealing and coronal elevation of the deep margin to a supragingival position using a direct bonded composite resin base. The deep margin elevation technique may be a useful noninvasive alternative to surgical crown lengthening. This technique may also facilitate the placement of large direct composite resin restorations. The fundamental principles of deep margin elevation are presented. (Am J Esthet Dent 2012;2:86–96.)