The Conundrum of Deep Marginal Acquisition A Comprehensive Review Article

Document Type : Review Article

Authors

1 Department of conservative dentistry, Faculty of Dentistry, Cairo University, Egypt.

2 Department of Conservative Dentistry , Faculty of Dentistry, Cairo University

3 Department of Periodontology, Faculty of Dentistry, Cairo University, Egypt.

10.21608/adjc.2024.326552.1642

Abstract

The biologic width is considered an important tight seal around the tooth, which is critical in protecting the periodontium from any microbial injury and maintaining periodontal health. However - in many clinical scenarios - subgingival carious lesions and crown-root fractures may affect the biologic width dimension. Deep marginal acquisition is considered a critical factor for clinical success. Several protocols were highlighted in this review to solve this conundrum, including the functional crown lengthening procedure, which is considered the gold standard of care for managing deep subgingival margins. However, it has its limitations, including the risk of causing root exposure, furcation involvement in posterior teeth with high furcation, compromising crown-root ratio, besides risking implant threads exposure if it was performed besides implant, extending crestal bone recontouring to buccal and lingual walls, and in some cases to adjacent teeth to attain smooth bony architecture, and the complications of surgery such as post-operative pain, inflammation, edema and the risk of excessive bleeding.

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