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Subgingival tartar removal9/7/2023 ![]() Subgingival margins, on either direct or indirect restorations, double the chances of periodontal bleeding upon probing. ![]() Side Effects of the Subgingival Margin Subgingival open margins, overhangs, and their devastating consequences to our patients’ periodontal health are the dirty little secrets of traditional restorative dentistry, as evident in Figures 1 to 3. This article will demonstrate, via 8 mini case reports, a minimally invasive supragingival protocol. In the author’s opinion, supragingival minimally invasive adhesive dentistry could, and should, fully replace traditional mechanically retained restorative dentistry. With the intentional goal of keeping the restorative margins supragingival, it is possible to predictably provide restorations that are healthier for patients. Traditionally, restorative margins ending subgingivally are considered out of the control of the restorative dentist but, in reality, subgingival margins are mostly avoidable and preventable! We have the techniques and materials to be able to consider all of the above a part of the history of dentistry. Prepping subgingival margins to hide the color of teeth or the restorative margin, final impression challenges with the use of a double-cord technique, cutting healthy tooth structure for boxes and axial walls for resistance and retention form, and dropping the gingival floor to create cervical clearance are some of the difficult and often unsuccessful techniques associated with subgingival margins and the more traditional approach to restorative preparation design. Nevertheless, millions of subgingival margins are placed unnecessarily every year. ![]() ![]() Subgingival margins are often unhealthy, causing permanently inflamed gingiva and permanent periodontal damage associated to bad restorative margins, as well as red (Figure 1), gray, and purple gums (Figure 2). INTRODUCTION The worst-kept secret to healthier and more predictable restorative dentistry is keeping margins supragingival, whenever possible. ![]()
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