GINGIVAL MARGIN ELEVATION AND INDIRECT RESTORATION IN MILLED COMPOSITE RESIN IN TOOTH WITH SUBGINGIVAL MARGIN: CASE REPORT

Abstract

Currently, dentistry tends to be more conservative, preserving dental tissue. The use of direct restorations and indirect partial restorations in composite resin, associated with biomimetic protocols, are examples of minimally invasive procedures. Teeth with extensive cavities and subgingival marginal endings are challenges for clinical practice, and in the search for more conservative protocols, deep margin elevation (DME) may be indicated. This work aims to demonstrate, through a clinical case, the importance of DME associated with the milled indirect restoration in composite resin, using the CAD-CAM system, in a tooth with a margin located beyond the cement-enamel junction (CEJ). The present case report described the restorative treatment of the upper left second premolar, which initially presented extensive caries under a composite resin restoration on the occlusal and mesial surfaces; and, after its removal, had the cervical margin of the mesial surface allocated subgingivally. The treatment option was composite resin DME, followed by endodontic treatment, sealing of the canal entrances, composite resin core build-up, and final restoration type onlay, also in composite resin, produced through the digitally assisted design and manufacturing system (CAD-CAM). The proposed treatment demonstrated that DME allows for the perfect adaptation of the restoration directly to the tooth, eliminating the need for clinical crown lengthening (CCL). Thus, an effective, quick treatment with lower comorbidity and reduced financial cost to the patient was achieved. After four months, the clinical and radiographic evaluation of the restoration showed good marginal adaptation, pleasant aesthetics, good polishing, and gingival health, with no signs of inflammation.

Keywords

• composite resin
• cad-cam
• dental marginal adaptation
• onlay dental
• biomimetic