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Coronal margin relocation (CMR) is a technique that is being increasingly used to manage subgingival defects in cavities in posterior teeth. The aim of this case report and literature review is to arm the dental practitioner with up-to-date scientific literature on this topic, such that they can appropriately incorporate CMR into their practice. Inclusion criteria for the literature review were the use of composite as the material used for CMR and a subsequent indirect restoration. Medline was searched and manual search of bibliographies was carried out. This yielded nine in vitro studies and 12 clinical reports that were considered in this review.
CPD/Clinical Relevance: The CMR technique is being used more widely in dental practice and it is important for dental practitioners to be aware of the evidence base on which to guide their practice.
Article
The management of subgingivally extending carious lesions in posterior teeth poses a common clinical scenario faced in dental practice. Traditionally, surgical and orthodontic crown lengthening has been used to increase crown height in such situations, although it may be considered that additional training would be needed for such techniques.1,2 The evolution of dental adhesive systems and restorative materials however, has led to the increased use of an alternative technique that first appeared in the literature in 1998: cervical margin relocation (CMR).3 It has since also been referred to as ‘deep margin elevation’ (DME) and ‘proximal box elevation’ (PBE), among other names. The technique advocates the direct addition of composite resin onto the cavity floors of posterior proximal subgingival defects to produce a supragingivally displaced margin,4 which can then be used as the margin for a further indirect or, less commonly, direct restoration.4,5 The rationale for this technique includes the improved ease of impression taking and isolation of the relocated margin, while being less invasive and more affordable than surgical crown lengthening options.4
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