Effect of Deep Margin Elevation on Periodontal Health and Gingival Microleakage: A Clinical and Microbiological Assessment

Abstract

Subgingival restorations pose significant clinical challenges due to their proximity to the gingival tissues and potential to disrupt periodontal health. Deep Margin Elevation (DME) has emerged as a minimally invasive technique aimed at relocating deep restorative margins coronally, thereby improving restorative access while preserving biological width. This study aimed to assess the effect of DME on periodontal health and gingival microleakage through combined clinical and microbiological evaluation. Patients requiring posterior restorations with subgingival margins were divided into two groups: restorations performed with DME and conventional restorations without margin elevation. Clinical parameters, including Plaque Index, Gingival Index, Probing Depth, and Clinical Attachment Level, were recorded at baseline, 3, 6, and 12 months. Microbiological analysis of gingival crevicular samples was performed to detect bacterial infiltration and assess marginal leakage. The results revealed that restorations performed with DME maintained stable periodontal parameters and demonstrated reduced gingival microleakage compared to conventional restorations, provided that isolation and adhesive protocols were properly executed. These findings indicate that DME, when performed under controlled conditions, supports periodontal health and minimizes bacterial penetration, confirming its clinical and biological compatibility in subgingival restorative procedures.