Deep Margin Elevation: Current Evidence and a Critical Approach to Clinical Protocols

Deep Margin Elevation (DME) is a widely adopted technique for managing subgingival cervical proximal margins by repositioning them to a supragingival location. This approach enhances access, visibility, and control in these anatomically challenging areas. This review aims to consolidate existing literature on the indications/contraindications, materials, clinical application steps, and longterm clinical outcomes of DME. A variety of materials have been investigated for use as the intermediate layer, with composite resins of varying viscosities and filler compositions being preferred due to their favorable long-term mechanical properties. However, more randomized clinical studies with sufficient follow-up are needed to determine the longevity of such restorations and to evaluate their impact on periodontal health. Understanding the indications, limitations, and protocol of DME is critical for achieving biologically sound and predictably functional restorations.