Enhancing Marginal Integrity and Interproximal Papilla Stability in Posterior Teeth Using Deep Margin Elevation with Ceramic Inlays/Onlays: A Clinical Report

Nissaf Daouahi*, Yosra Gassara, Rim Kallala, Sarra Nasri and Zohra Nouira

Background: Defective posterior restorations with inadequate proximal morphology are commonly associated with plaque accumulation and localised periodontal inflammation. Restorative strategies that re-establish both marginal integrity and interproximal architecture are essential for maintaining periodontal health. Adhesively bonded ceramic inlays/onlays, associated with Deep margin elevation, provide a conservative option with favourable mechanical and biological outcomes.

Case presentation: A 32-year-old female patient presented with discomfort in the left posterior region, recurrent food impaction, and bleeding during oral hygiene procedures. Clinical examination revealed extensive defective restorations on teeth 36 and 37, characterised by loss of marginal ridges, deep proximal–occlusal lesions, and altered interproximal contours, contributing to plaque retention and papillary inflammation.

Management: Indirect lithium disilicate inlay/onlay restorations were planned. Deep margin elevation was performed to relocate subgingival margins coronally, facilitating adequate isolation and adhesive procedures. Restorations were designed to restore proximal contact, anatomical contours, and occlusal function, with optimal marginal adaptation.

Outcome: The definitive restorations achieved satisfactory marginal integrity and functional occlusion, with good aesthetic integration. Clinically, symptoms resolved, food impaction was eliminated, and oral hygiene improved. The interproximal papilla showed clear stabilisation, with resolution of inflammation.

Conclusion: Lithium disilicate inlays/onlays, combined with deep margin elevation and strict adhesive protocols, represent a predictable and biologically sound approach for restoring marginal integrity and interproximal tissue stability in posterior teeth with extensive structural loss.

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Published on: Apr 23, 2026 Pages: 7-12

Full Text PDF Full Text HTML DOI: 10.17352/2394-8418.000135
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