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Deep Margin Elevation and Clinical Crown Lengthening: Biological considerations and clinical procedures

The restoration of a severely compromised tooth represents a challenge for the clinician, not only due to a significant loss of structure of the element but also due to the invasion of the supracrestal tissue attachment, with consequent compromization of periodontal health.
The technique of deep margin elevation can be applied when the healthy margin of the tooth needing restoration is localized within the sulcular epithelium or at the level of the junctional epithelium.
On the other side, the presence of lesions of the dental element involving the space for the supracrestal connective attachment and/or the bone crest makes the surgical intervention necessary. The following article aims to describe the indications and surgical procedures for clinical crown lengthening from a biological, periodontal and biomechanical point of view. 
Therefore, the operational steps of the clinical crown lengthening surgical procedure (bone-resective surgery) and the sub- sequent endodontic/restorative clinical phases will be illustrated.

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ENDO-PERIO LESIONS: SIMPLIFIED CLASSIFICATION

Periodontium and pulpal spaces represent the two primary modes of dental infection from oral bacteria.
At the clinical level, compound dentoalveolar infections involving both tissues are common and present challenges for diagnosis and treatment. The complex lesions presenting the characteristics of both endodontic and periodontic infections are referred to as endo-periodontal lesions (EPLs).

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Restoring the unrestorable: Surgical extrusion

One of the main objectives of dentistry is the preservation of the natural dentition.1 Carious lesions, dental trauma, root resorptions or iatrogenic procedures such as root perforations can cause the loss of healthy dental tissue. When the loss of dental tissue occurs at the subgingival level; the restorability of these teeth is seriously compromised.2 In […]

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Deep caries due to pre-eruptive intracoronal resorption (PIER) in a recently erupted maxillary second molar: a case report

A pre-eruptive intra-coronal resorption (PIER) is a defect located in the dentin of an unerupted tooth, just beneath the dentin-enamel junction.  The depth of the lesion is variable and may also reach the pulp, like in this 13 years old patient.  In the past, these lesions were confused with caries, and were therefore called “hidden” […]

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Management of a tooth with primary periodontal lesion with AF F One

Endo pero lesions of primary periodontal organ can be diffcult to diagnose. A multidisciplinary approach is mandatory to solve the case

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Adhesive Direct Restoration in the Posterior Area with Subgingival Cervical Margins

Localized subgingival margins can complicate the use of direct adhesive restorations and subsequently hinder their durability and relation with the periodontal tissues. This article presents a technique involving placement of a modified matrix followed by immediate dentin sealing and coronal elevation of the deep margin to a supra- gingival position using a direct bonded composite […]

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Interactions Between Endodontics and Periodontics: Part I

Understanding the interaction between endodontics and periodontics is of crucial importance to the clinician because of the challenges frequently encountered in the assessment, diagnosis, treatment and prognosis of combined endodontic–periodontal diseases. Treatment and prognosis of endodontic–periodontal diseases vary, depending on the etiology, pathogenesis and correct recognition of each specific condition. Therefore, understanding the interrelationship between […]

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