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Scripta Scientifica Medicinae Dentalis

Cervical margin relocation - basic principles and influence on the periodontal tissues

Sabina Keremedchieva, Stefan Peev, Angela Gusiyska, Elitsa Sabeva

Abstract

INTRODUCTION: Cervical margin relocation (CMR) involves the placement of a base layer of direct resin composite material in order to elevate the proximal cavity margins located below the gingiva. CMR is applied prior to the cementation of indirect bonded restorations.

AIM: The aim of this review is to briefly present the basic principles of the CMR technique and to assess whether the execution of this method before the cementation of indirect bonded restorations is beneficial to the long-term outcome of the treatment and to the periodontal tissues according to the literature.

MATERIALS AND METHODS: This review includes articles searched without date restriction in the Medline/PubMed database along with bibliographic data. A variety of keywords and their combinations were used: "cervical margin relocation", "proximal box elevation", "indirect restorations", "adhesion", "marginal adaptation", "marginal sealing", "deep margin elevation".

RESULTS: The review is based upon 41 references. The literature data provided information on the basic principles of cervical margin relocation and its relation to periodontal health.

CONCLUSION: Further research, scientific evidence and longer follow-up results are needed in order to conclude that CMR is entirely beneficial to the long-term outcome of the treatment and to the periodontal tissues.


Keywords

cervical margin relocation; proximal box elevation; indirect restorations

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References

Dietschi D, Spreafico R. Current clinical concepts for adhesive cementation of toothcolored posterior restorations. Pract Periodontics Aesthet Dent. 1998;10(1):47-54.

Magne P, Spreafico R. Deep margin elevation: a paradigm shift. Am J Esthet Dent. 2012;2(2):86–96.

Juloski J, KÖken S, Ferrari M. No correlation between two methodological approaches applied to evaluate cervical margin relocation. Dent Mater J. 2020;39(4):624-32. doi: 10.4012/dmj.2018-410.

Lefever D, Gregor L, Bortolotto T, Krejci I. Supragingival relocation of subgingivally located margins for adhesive inlays/onlays with different materials. J Adhes Dent. 2012;14(6):561-7. doi: 10.3290/j.jad.a27795.

Kielbassa AM, Philipp F. Restoring proximal cavities of molars using the proximal box elevation technique: systematic review and report of a case. Quintessence Int. 2015;46(9):751–64. doi: 10.3290/j.qi.a34459.

Rocca GT, Rizcalla N, Krejci I, Dietschi D. Evidence-based concepts and procedures for bonded inlays and onlays. Part II. Guidelines for cavity preparation and restoration fabrication. Int J Esthet Dent. 2015;10(3):392–413.

Veneziani M. Adhesive restorations in the posterior area with subgingival cervical margins: new classification and differentiated treatment approach. Eur J Esthet Dent. 2010;5(1):50–76.

D’Arcangelo C, Vanini L, Casinelli M, Frascaria M, De Angelis F, Vadini M, et al. Adhesive cementation of indirect composite inlays and onlays: a literature review. Compend Contin Educ Dent. 2015;36(8):570–7 quiz 8.

Keys W, Carson SJ. Rubber dam may increase the survival time of dental restorations. Evid Based Dent. 2017;18(1):19–20. doi: 10.1038/sj.ebd.6401221.

Small BW. Rubber dam--the easy way. Gen Dent. 1999;47(1):30-3. PMID: 10321148.

Zou H, Wang Y, Zhang H, Shen J, Liu H. [An overview on rubber dam application in dental treatments]. Zhonghua Kou Qiang Yi Xue Za Zhi. 2016;51(2):119-23. Chinese. doi: 10.3760/cma.j.issn.1002-0098.2016.02.011.

Cardoso MV, de Almeida Neves A, Mine A, Coutinho E, Van Landuyt K, De Munck J, et al. Current aspects on bonding effectiveness and stability in adhesive dentistry. Aust Dent J. 2011;56(Suppl. 1):31–44. doi: 10.1111/j.1834-7819.2011.01294.x.

Breschi L, Mazzoni A, Ruggeri A, Cadenaro M, Di Lenarda R, De Stefano Dorigo E. Dental adhesion review: aging and stability of the bonded interface. Dent Mater. 2008;24(1):90–101. doi: 10.1016/j.dental.2007.02.009.

Perdigao J. Dentin bonding as a function of dentin structure. Dent Clin North Am. 2002;46(2):277–301 vi. doi: 10.1016/s0011-8532(01)00008-8.

Dietschi D, Spreafico R. Evidence-based concepts and procedures for bonded inlays and onlays. Part I. Historical perspectives and clinical rationale for a biosubstitutive approach. Int J Esthet Dent. 2015;10(2):210–27.

Köken S, Juloski J, Sorrentino R, Grandini S, Ferrari M. Marginal sealing of relocated cervical margins of mesio-occluso-distal overlays. J Oral Sci. 2018;60(3):460-8. doi: 10.2334/josnusd.17-0331.

Truffier-Boutry D, Gallez X, Demoustier-Champagne S, Devaux J, Mestdagh M, Champagne B, et al. Identification of free radicals trapped in solid methacrylated resins. J Polym Sci Pol Chem. 2003; 41(11):1691-9. doi:10.1002/pola.10692.

Jorgensen KD. Restorative resins: Abrasion vs mechanical properties. Scand J Dent Res. 1980;88(6):557-568. doi: 10.1111/j.1600-0722.1980.tb01267.x.

Mc Cabe JF, Ogden AR. The relationship between porosity compressive fatigue limit and wear in the resin compositre restorative materials. Dent Mater. 1987;3(1):9-12. doi: 10.1016/s0109-5641(87)80053-2.

Tantbirojn D, Versuluis A, Cheng YS, Douglas WF. Fracture toughness and microhardness of a composite: Do they correlate? J Dent. 2003;31(2):89-95. doi: 10.1016/s0300-5712(03)00008-3.

Van Dijken JW, Ruyter IE, Holland AI. Porosity in posterior resin composites. Scand J Dent Res. 1986;94(5):471-8. doi: 10.1111/j.1600-0722.1986.tb01789.x.

Drummond JL. Degradation, fatigue, and failure of resin dental composite materials. J Dent Res. 2008;87(8):710-9. doi: 10.1177/154405910808700802.

Opdam NJ, Roeters JJ, Joosten M, Veeke O. Porosities and voids in Class I restorations placed by six operators using a packable or syringable composite. Dent Mater. 2002;18(1):58-63. doi: 10.1016/s0109-5641(01)00020-3.

Bresser RA, Gerdolle D, van den Heijkant IA, Sluiter-Pouwels LMA, Cune MS, Gresnigt MMM. Up to 12 years clinical evaluation of 197 partial indirect restorations with deep margin elevation in the posterior region. J Dent. 2019;91:103227. doi: 10.1016/j.jdent.2019.103227.

Dietschi D, Spreafico R. Adhesive metal-free restorations: current concepts for the esthetic treatment of posterior teeth. Quintessence Pub Co; 1997. pp. 60-77.

Ferrari M, Cagidiaco MC, Davidson CL. Resistance of cementum in Class II and V acvities to penetration by an adhesive system. Dent Mater. 1997;13(3):157-62. doi: 10.1016/S0109-5641(97)80117-0.

Tjäderhane L, Nascimento FD, Breschi L, Mazzoni A, Tersariol IL, Geraldeli S, et al. Optimizing dentin bond durability: control of collagen degradation by matrix metalloproteinases and cysteine cathepsins. Dent Mater. 2013;29(1):116-35. doi: 10.1016/j.dental.2012.08.004.

Liu Y, Tjäderhane L, Breschi L, Mazzoni A, Li N, Mao J, Pashley DH, Tay FR. Limitations in bonding to dentin and experimental strategies to prevent bond degradation. J Dent Res. 2011;90(8):953-68. doi: 10.1177/0022034510391799.

Nevins M, Skurow HM. The intracrevicular restorative margin, the biologic width, and the maintenance of the gingival margin. Int J Periodontics Restorative Dent. 1984;4(3):30-49.

Padbury Jr. A, Eber R, Wang HL. Interactions between the gingiva and the margin of restorations. J Clin Periodontol. 2003;30(5):379-85. doi: 10.1034/j.1600-051x.2003.01277.x.

Broadbent JM, Williams KB, Thomson WM, Williams SM. Dental restorations: a risk factor for periodontal attachment loss? J Clin Periodontol. 2006;33(11):803-10. doi: 10.1111/j.1600-051X.2006.00988.x.

Kamin S. The biologic width--periodontal-restorative relationship. Singapore Dent J. 1989;14(1):13-5.

Ingber JS, Rose LF, Coslet JG. The “biologic width”—a concept in periodontics and restorative dentistry. Alpha Omegan. 1977;70(3):62–5.

Chapple ILC, Mealey BL, Van Dyke TE, Bartold PM, Dommisch H, Eickholz P, etal. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018;89(Suppl 1):S74-S84. doi: 10.1002/JPER.17-0719.

Ferrari M, Koken S, Grandini S, Ferrari Cagidiaco E, Joda T, Discepoli N. Influence of cervical margin relocation (CMR) on periodontal health: 12-month results of a controlled trial. J Dent. 2018;69:70-76. doi: 10.1016/j.jdent.2017.10.008.

Schatzle M, Land NP, Anerud A, Boysen H, Burgin W, Loe H. The influence of margins of restorations of the periodontal tissues over 26 years. J Clin Periodontol. 2001;28(1):57–64. doi: 10.1034/j.1600-051x.2001.280109.x.

Valderhaug J, Ellingsen JE, Jokstad A. Oral hygiene, periodontal conditions and carious lesions in patients treated with dental bridges. A 15-year clinical and radiographic follow-up study. J Clin Periodontol. 1993;20(7):482-9. doi: 10.1111/j.1600-051x.1993.tb00395.x.

Paniz G, Nart J, Gobbato L, Mozzocco, Stellini E, De Simone G, et al. Clinical periodontal response to anterior all-ceramic crowns with either chamfer or featheredge subgingival tooth preparations: Six-month results and patient perception. Int J Period Rest Dent. 2017;37(1):61-8. doi: 10.11607/prd.2765.

Lang NP, Kiel RA, Anderhalden K. Clinical and microbiological effects of subgingival restorations with overhanging or clinically perfect margins. J Clin Periodontol. 1983;10(6):563-78. doi: 10.1111/j.1600-051x.1983.tb01295.x.

Morimoto S, Rebello de Sampaio FB, Braga MM, Sesma N, Ozcan M. Survival rate of resin and ceramic inlays, onlays, and overlays: a systematic review and meta-analysis. J Dent Res. 2016;95(9):985-94. doi: 10.1177/0022034516652848.

Mangani F, Marini S, Barabanti N, Preti A, Cerutti A. The success of indirect restorations in posterior teeth: a systematic review of the literature. Minerva Stomatol. 2015;64(5):231–40.




DOI: http://dx.doi.org/10.14748/ssmd.v6i2.7377

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About The Authors

Sabina Keremedchieva
Medical University of Varna
Bulgaria

Department of Periodontology and Dental Implantology, Faculty of Dental Medicine

Stefan Peev
Medical University of Varna
Bulgaria

Department of Periodontology and Dental Implantology, Faculty of Dental Medicine

Angela Gusiyska
Medical University of Sofia
Bulgaria

Department of Conservative Dentistry, Faculty of Dental Medicine

Elitsa Sabeva
Medical University of Varna
Bulgaria

Department of Periodontology and Dental Implantology, Faculty of Dental Medicine

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