Clinical Longevity of Deep Margin Elevation Techniques in Posterior Teeth Restored with CAD/CAM Materials

Abstract

The clinical management of deep subgingival margins in posterior teeth remains a significant restorative challenge, particularly when aiming to preserve tooth structure and ensure long-term success. Deep Margin Elevation (DME) has emerged as a minimally invasive alternative to surgical procedures, allowing coronal relocation of margins to facilitate adhesive bonding and digital restorative workflows. This study evaluated the clinical longevity of DME techniques in posterior teeth restored with various CAD/CAM materials, including lithium disilicate, zirconia-reinforced ceramics, and hybrid ceramics. Parameters assessed included marginal integrity, fracture resistance, periodontal response, and restoration survival rates over defined follow-up periods. Results from current clinical evidence indicate that restorations performed with DME demonstrate high survival rates and stable marginal adaptation when proper adhesive protocols and restorative materials are employed. CAD/CAM restorations bonded over elevated margins show comparable longevity to conventionally placed restorations, with minimal biological or mechanical complications. These findings affirm that DME, combined with advanced CAD/CAM technology, offers a reliable and conservative approach for the long-term restoration of posterior teeth with subgingival margins.