{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T13:40:32Z","timestamp":1794490832299,"version":"4.9.1"},"reference-count":34,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T00:00:00Z","timestamp":1698969600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: This review focuses on reviewing studies from the literature regarding the effects of deep margin elevation on the surrounding periodontium. Materials and Methods: A review of the literature was carried out using the following online databases: Embase, The Cochrane Library, MEDLINE-PubMed and Google Scholar. Our search was limited to articles from 2010 to 2023. The search terms consisted of keywords and MeSH terms, which were \u2018deep margin elevation\u2019, \u2018coronal margin relocation\u2019, \u2018periodontium\u2019 and \u2018periodontal tissues\u2019. The literature was searched thoroughly by two reviewers. Initially, the titles of the articles were extracted. After removing irrelevant and duplicate articles, abstracts were assessed for relevant articles. Finally, the reviewers analyzed full-text articles. Results: A total of twelve articles, including one randomized clinical trial, three systematic reviews, two prospective cohort, three case series, one a clinical study, one pilot study and one a retrospective study, were selected and analyzed. Conclusions: The review suggests potential benefits of Deep Margin Elevation (DME) over surgical crown lengthening due to reduced invasiveness, yet conclusive effects on periodontal tissue remain unclear, warranting further studies on clinical parameters and inflammatory biomarkers.<\/jats:p>","DOI":"10.3390\/medicina59111948","type":"journal-article","created":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T10:51:28Z","timestamp":1699008688000},"page":"1948","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Relationship between Deep Marginal Elevation and Periodontal Parameters: A Systematic Review"],"prefix":"10.3390","volume":"59","author":[{"given":"Mohammed Fareed","family":"Felemban","sequence":"first","affiliation":[{"name":"Department of Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Taif University, Taif 21944, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3502-3555","authenticated-orcid":false,"given":"Osama","family":"Khattak","sequence":"additional","affiliation":[{"name":"Department of Restorative Dental Sciences, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thani","family":"Alsharari","sequence":"additional","affiliation":[{"name":"Department of Restorative and Dental Science, Faculty of Dentistry, Taif University, Taif 21944, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrahman H.","family":"Alzahrani","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry, Taif University, Taif 21944, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3178-9513","authenticated-orcid":false,"given":"Kiran Kumar","family":"Ganji","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia"},{"name":"Department of Periodontology & Oral Implantology, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education & Research, Sawangi (Meghe), Wardha 442107, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4769-6653","authenticated-orcid":false,"given":"Azhar","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Department of Restorative Dental Sciences, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,3]]},"reference":[{"key":"ref_1","first-page":"1384","article-title":"Biomimetics in dentistry\u2014A review","volume":"2","author":"Viswanath","year":"2014","journal-title":"Indian J. Res. Pharm. Biotechnol."},{"key":"ref_2","first-page":"10","article-title":"Impact of Deep Margin Elevation Procedures Upon Periodontal Parameters: A Systematic Review","volume":"31","author":"Chun","year":"2023","journal-title":"Eur. J. Prosthodont. Restor. Dent."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/j.identj.2021.08.048","article-title":"Deep margin elevation for indirect bonded restorations: A case report","volume":"71","author":"Ayari","year":"2021","journal-title":"Int. Dent. J."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Aldakheel, M.A.K., Alnafissah, S.A.R., Alqahtani, A., and Almuhtab, N. (2022). Deep Margin Elevation: Current Concepts and Clinical Considerations: A Review. Medicina, 58.","DOI":"10.3390\/medicina58101482"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"12","DOI":"10.4103\/0972-0707.92599","article-title":"Biologic width and its importance in periodontal and restorative dentistry","volume":"15","author":"Nugala","year":"2012","journal-title":"J. Conserv. Dent."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S237","DOI":"10.1002\/JPER.17-0733","article-title":"Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions","volume":"89","author":"Jepsen","year":"2018","journal-title":"J. Periodontol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1902\/jop.1961.32.3.261","article-title":"Dimensions and relations of the dentogingival junction in humans","volume":"32","author":"Gargiulo","year":"1961","journal-title":"J. Periodontol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1111\/jerd.13008","article-title":"Deep margin elevation-Present status and future directions","volume":"35","author":"Eggmann","year":"2023","journal-title":"J. Esthet. Restor. Dent."},{"key":"ref_9","first-page":"334","article-title":"Deep Margin Elevation Versus Crown Lengthening: Biologic Width Revisited","volume":"13","author":"Sarfati","year":"2018","journal-title":"Int. J. Esthet. Dent."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"23","DOI":"10.9734\/jpri\/2021\/v33i37B32016","article-title":"Deep margin elevation for indirect restorations: A systematic review","volume":"33","author":"Alghulikah","year":"2021","journal-title":"J. Pharm. Res. Int."},{"key":"ref_11","first-page":"25","article-title":"The Impact of Deep Marginal Elevation on the Periodontium: A Review Article","volume":"6","author":"Babkair","year":"2023","journal-title":"Sci. Arch. Dent. Sci."},{"key":"ref_12","first-page":"86","article-title":"Deep margin elevation: A paradigm shift","volume":"2","author":"Magne","year":"2012","journal-title":"Am. J. Esthet. Dent."},{"key":"ref_13","first-page":"26","article-title":"Rethinking deep marginal extension (DME)","volume":"7","year":"2018","journal-title":"Int. J. Cosmet. Dent."},{"key":"ref_14","first-page":"272","article-title":"Cervical margin relocation: Case series and new classification system","volume":"14","author":"Ghezzi","year":"2019","journal-title":"Int. J. Esthet. Dent."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"175","DOI":"10.36377\/1683-2981-2021-19-3-175-183","article-title":"Deep margin elevation: A systematic review","volume":"19","author":"Shilyaeva","year":"2021","journal-title":"Endod. Today"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"103227","DOI":"10.1016\/j.jdent.2019.103227","article-title":"Up to 12 years clinical evaluation of 197 partial indirect restorations with deep margin elevation in the posterior region","volume":"91","author":"Bresser","year":"2019","journal-title":"J. Dent."},{"key":"ref_17","first-page":"118","article-title":"Evidence-based concepts and procedures for bonded inlays and onlays. Part III. A case series with long-term clinical results and follow-up","volume":"14","author":"Dietschi","year":"2019","journal-title":"Int. J. Esthet. Dent."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Mugri, M.H., Sayed, M.E., Nedumgottil, B.M., Bhandi, S., Raj, A.T., Testarelli, L., Khurshid, Z., Jain, S., and Patil, S. (2021). Treatment Prognosis of Restored Teeth with Crown Lengthening vs. Deep Margin Elevation: A Systematic Review. Materials, 14.","DOI":"10.3390\/ma14216733"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1007\/s00784-019-02998-7","article-title":"Clinical and histological reaction of periodontal tissues to subgingival resin composite restorations","volume":"24","author":"Bertoldi","year":"2020","journal-title":"Clin. Oral. Investig."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.jdent.2017.10.008","article-title":"Influence of cervical margin relocation (CMR) on periodontal health: 12-month results of a controlled trial","volume":"69","author":"Ferrari","year":"2018","journal-title":"J. Dent."},{"key":"ref_21","first-page":"335","article-title":"Retrospective Clinical Evaluation of Subgingival Composite Resin Restorations with Deep-Margin Elevation","volume":"24","author":"Muscholl","year":"2022","journal-title":"J. Adhes. Dent."},{"key":"ref_22","first-page":"154","article-title":"The dimensions of the human dentogingival junction","volume":"14","author":"Vacek","year":"1994","journal-title":"Int. J. Periodontics Restor. Dent."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s13191-011-0101-x","article-title":"Biologic perspectives in restorative treatment","volume":"11","author":"Savadi","year":"2011","journal-title":"J. Indian Prosthodont. Soc."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Galler, K.M., Weber, M., Korkmaz, Y., Widbiller, M., and Feuerer, M. (2021). Inflammatory Response Mechanisms of the Dentine-Pulp Complex and the Periapical Tissues. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22031480"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"22","DOI":"10.2341\/13-052-T","article-title":"Proximal Box Elevation with Resin Composite and the Dogma of Biological Width: Clinical R2-Technique and Critical Review","volume":"39","author":"Frese","year":"2014","journal-title":"Oper. Dent."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"117","DOI":"10.11607\/prd.2015","article-title":"Response to Proximal Restorations Placed Either Subgingivally or Following Crown Lengthening in Patients with No History of Periodontal Disease","volume":"36","author":"Oppermann","year":"2016","journal-title":"Int. J. Periodontics Restor. Dent."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"85","DOI":"10.5177\/ntvt.2023.02.22097","article-title":"Deep Margin Elevation for adhesive indirect restorations","volume":"130","author":"Bresser","year":"2023","journal-title":"Ned. Tijdschr. Tandheelkd."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Samartzi, T.K., Papalexopoulos, D., Ntovas, P., Rahiotis, C., and Blatz, M.B. (2022). Deep Margin Elevation: A Literature Review. Dent. J., 10.","DOI":"10.3390\/dj10030048"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.4103\/jfmpc.jfmpc_1707_20","article-title":"Assessment of knowledge, attitude, and practice regarding Deep Margin Elevation (DME) among dental practitioners in Riyadh, Saudi Arabia","volume":"10","author":"Binalrimal","year":"2021","journal-title":"J. Fam. Med. Prim. Care"},{"key":"ref_30","first-page":"142","article-title":"Deep margin elevation","volume":"18","author":"Bresser","year":"2023","journal-title":"Int. J. Esthet. Dent."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"217","DOI":"10.2174\/1874210601509010217","article-title":"Iatrogenic Damage to Periodontium by Restorative Treatment Procedures: An Overview","volume":"9","author":"Sirajuddin","year":"2015","journal-title":"Open Dent. J."},{"key":"ref_32","first-page":"116","article-title":"Clinical and Radiographic Evaluation of the Periodontium with Biologic Width Invasion by Overextending Restoration Margins\u2014A Pilot Study","volume":"17","author":"Maravilha","year":"2015","journal-title":"J. Int. Acad. Periodontol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"387","DOI":"10.22271\/oral.2021.v7.i3f.1327","article-title":"Deep margin elevation: Raising the bar in adhesive restorations\u2014A case series","volume":"7","author":"Furtado","year":"2021","journal-title":"Int. J. Appl. Dent. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"225","DOI":"10.4103\/0971-6580.103652","article-title":"Release and toxicity of dental resin composite","volume":"19","author":"Gupta","year":"2012","journal-title":"Toxicol. Int."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/11\/1948\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:16:37Z","timestamp":1760130997000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/11\/1948"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,3]]},"references-count":34,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["medicina59111948"],"URL":"https:\/\/doi.org\/10.3390\/medicina59111948","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,3]]}}}