Restorative Dentistry Dichotomy

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There exists an intimate relationship between periodontal health and the restoration of teeth. The maintenance of gingival health has a direct impact on the longevity of the teeth and associated restorations. Therefore, a good clinician requires an adequate understanding of the relationship between periodontal tissues and restorative dentistry and its impact on the form, function, aesthetics, and comfort of the dentition.
The teeth are embedded into the bone of the maxilla or the mandible. The biologic width is a protective seal existing around the teeth to protect the alveolar bone against bacterial infection (Rajendran et al., 2014). ‘The biological width is defined as the dimension of the soft tissue, which is attached to the portion of the tooth coronal to the crest of the alveolar bone (Nugula, et al. 2012)’. Gargiulo et al. (1961) described the dimensions and relationship of the dentogingival junction in humans. Based on his
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Providing sub-gingival margins provides excellent aesthetics, but at the same time acts as a permanent irritant to the periodontium. A high degree chance of Biologic width encroachment exists when planning for subgingival restorations. Hence, limiting subgingival margin extension to 0.5-1.0 mm is recommended because as it is highly difficult for the clinician to detect where the sulcular epithelium ends and the junctional epithelium begins (Nugula et al. 2012).
Biologic width violation causes serious consequences like chronic progressive gingival inflammation, clinical attachment loss and alveolar bone loss. Destructive inflammatory response to plaque located at deep pockets can cause the above diseases. Gingival hyperplasia is also most frequently found in subgingivally placed restorative margins (Rajendran,
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