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Deep Margin Elevation: Preserving More of Your Natural Tooth
In carefully selected cases, deep margin elevation uses adhesive bonding to raise a deep restoration margin, allowing an onlay, overlay, or crown while preserving surrounding gum tissue and bone. At Enso Dentistry, we assess whether DME or clinical crown lengthening is the better option for your tooth.
Looking for Deep Margin Elevation near Redmond and Bellevue?
In carefully selected cases, deep margin elevation uses adhesive bonding to raise a deep restoration margin, allowing an onlay, overlay, or crown while preserving surrounding gum tissue and bone. At Enso Dentistry, we assess whether DME or clinical crown lengthening is the better option for your tooth.
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Deep Margin Elevation: A Conservative Option
Deep margin elevation (DME) uses bonded composite resin to raise a deep cavity margin to an accessible level, allowing a conservative restoration without the need for clinical crown lengthening in many cases.
- Deep cavity below the gumline. A deep cavity extends slightly below the gumline, but it remains coronal to the supracrestal tissue attachment and bone. The diagram labels the deep cavity, gumline, and supporting bone.
- Deep margin elevation. The deep margin is elevated with bonded composite resin, moving the restorative margin to a more accessible and cleanable location above the gumline. The diagram labels the bonded composite, new accessible margin, and preserved bone.
- Final bonded onlay. A final ceramic onlay (or crown) is placed over the elevated margin, with healthy, stable gum tissues and no need for clinical crown lengthening. The diagram labels the ceramic onlay, natural gumline, and preserved supporting bone.
DME is suitable only when isolation and periodontal tissue health can be maintained. Crown lengthening may still be necessary in cases with inadequate isolation, subgingival caries extending into the attachment or bone, or periodontal concerns.
Have you been advised that you need a crown lengthening procedure in order to save a tooth? Sometimes, a cavity or an old restoration extends deep beneath the gumline, making it difficult to restore the tooth predictably. Traditionally, these situations may require a surgical procedure called clinical crown lengthening, in which gum tissue and sometimes supporting bone are removed to expose more of the tooth. While crown lengthening is sometimes necessary, it can alter the gumline, expose additional root surface, and remove healthy supporting bone.
Deep Margin Elevation (DME) offers a more conservative and a slightly different alternative in carefully selected cases. Using adhesive bonding techniques, we can rebuild the deep portion of the tooth with a tooth-colored restorative material, bringing the margin of the future restoration to a more accessible position. This allows us to place and bond an onlay, overlay, or crown more predictably while preserving the surrounding gum tissue and bone.
At Enso Dentistry, our philosophy is preservation over preparation. Whenever clinically appropriate, we favor techniques that conserve healthy tooth structure and minimize surgical intervention. Deep margin elevation is one of the ways we can restore a compromised tooth while respecting its natural biology. Not every deep cavity is suitable for this approach, however. The depth of the defect, the health of the surrounding tissues, and our ability to achieve a reliable seal all help determine whether DME or crown lengthening is the better option.
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Helpful Answers
Clear answers for patients researching carefully.
These short answers are for patients who are comparing cosmetic dentistry, credentials, location, and the kind of care they want.
Can deep margin elevation be an alternative to crown lengthening?
In carefully selected cases, deep margin elevation can raise a deep restoration margin using adhesive bonding while preserving surrounding gum tissue and bone. Clinical crown lengthening is still necessary in some situations.
What restorations can be placed after deep margin elevation?
An onlay, overlay, or crown can be placed and bonded after the deep portion of the tooth has been rebuilt and the restoration margin brought to a more accessible position.
Is every deep cavity suitable for deep margin elevation?
No. The depth of the defect, the health of the surrounding tissues, and the ability to achieve a reliable seal help determine whether DME or crown lengthening is the better option.