Deep Margin Elevation

The management of deeply situated subgingival margins has long represented one of the most formidable challenges in restorative dentistry, historically compelling clinicians to resort to surgically invasive modalities such as crown lengthening or orthodontic extrusion - procedures that carry inherent risks of periodontal compromise, aesthetic disfigurement, and delayed treatment timelines. This chapter traces the conceptual and technical evolution of a transformative conservative paradigm: from the early open sandwich technique pioneered by McLean and Wilson in the late 1970s, which first introduced the deliberate placement of glass ionomer cement at deep cervical margins to improve adhesion and biological sealing, to the refined concept of Cervical Margin Relocation formally proposed by Dietschi and Spreafico in 1998, and ultimately to the widely accepted terminology of Deep Margin Elevation (DME) advocated by Magne and Spreafico as a genuine paradigm shift in adhesive restorative practice.