Eggmann Florin, Ayub Jose M, Conejo Julián, Blatz Markus B
Department of Preventive and Restorative Sciences, Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Department of Periodontology, Endodontology, and Cariology, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland.
J Esthet Restor Dent. 2023 Jan;35(1):26-47. doi: 10.1111/jerd.13008. Epub 2023 Jan 5.
Deep margin elevation (DME) is a treatment approach to relocate the cervical margin of teeth with subgingival defects to a supragingival position with a direct restoration to facilitate rubber dam isolation, impression taking, and bonding of indirect restorations. This article provides an overview of the current scientific evidence on DME and future directions for research.
The review included 38 studies on DME, most conducted in vitro. These studies indicate that DME has no detrimental effect on the fracture resistance of restored teeth. Evidence on the impact of DME on marginal quality is conflicting, but most in vitro studies observed no negative effect. Clinical studies, most comprising small patient cohorts, demonstrated favorable restorative outcomes and suggest that DME restorations made with scrupulous care are compatible with periodontal health. Bleeding on probing may occur more frequently at sites with DME, though evidence on this is not unequivocal.
Current evidence, based largely on laboratory studies and limited clinical data, supports DME as a viable approach to restore teeth with localized subgingival defects. However, further clinical studies with long-term follow-ups are required to provide corroborative evidence.
Current evidence suggests that DME is a viable approach to restore teeth with localized subgingival defects as a possible alternative to surgical crown lengthening. Proper working field isolation, meticulous care in the bonding and buildup procedure, and biofilm removal through patient-performed oral hygiene and professional maintenance care are crucial. As scant clinical trial-based evidence is available today, further research is needed to evaluate the long-term performance of DME restorations and their impact on periodontal health.
深部边缘提升术（DME）是一种治疗方法，通过直接修复将存在龈下缺损的牙齿颈部边缘重新定位到龈上位置，以利于橡皮障隔离、取印模以及间接修复体的粘结。本文概述了目前关于DME的科学证据以及未来的研究方向。
该综述纳入了38项关于DME的研究，大多数为体外研究。这些研究表明，DME对修复后牙齿的抗折性没有不利影响。关于DME对边缘质量影响的证据存在矛盾，但大多数体外研究未观察到负面影响。临床研究大多纳入的患者队列较小，显示出良好的修复效果，并表明精心进行的DME修复与牙周健康相容。在进行DME的部位探诊出血可能更频繁发生，不过这方面的证据并不明确。
目前的证据主要基于实验室研究和有限的临床数据，支持DME作为修复局部龈下缺损牙齿的一种可行方法。然而，需要进一步的长期随访临床研究来提供确证。
目前的证据表明，DME作为手术冠延长术的一种可能替代方法，是修复局部龈下缺损牙齿的可行方法。合适的术野隔离、粘结和堆塑过程中的精心操作以及通过患者进行口腔卫生维护和专业维护护理来去除生物膜至关重要。由于目前基于临床试验的证据很少，需要进一步研究来评估DME修复体的长期性能及其对牙周健康的影响。
