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Dentistry Journal
Volume 14
Issue 3
10.3390/dj14030161
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Article

The Perio-Resto Interface: In Vitro Comparison of Two Deep Margin Elevation Techniques on Surface Roughness, Marginal Adaptation and Material Integrity

by
Pablo Cores Ziskoven
1,*,
Dorothea Vogel
1,
Sven Schumann
2,
David Kiramira
1,
Thanya Nguyen
1,
Andreas M. Geyer
1,
Jens Weusmann
1 and
James Deschner
1
1
Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
2
Institute of Anatomy, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
*
Author to whom correspondence should be addressed.
Dent. J. 2026, 14(3), 161; https://doi.org/10.3390/dj14030161
Submission received: 2 February 2026 / Revised: 22 February 2026 / Accepted: 28 February 2026 / Published: 11 March 2026
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Abstract

Background/Objectives: Deep subgingival proximal carious lesions present significant restorative and periodontal challenges, especially when approaching the supracrestal attachment (SA). This study compared two established deep margin elevation (DME) tecniques—the modified matrix technique (MMT) and the matrix-free “R2 technique” (R2T)—with respect to surface roughness, marginal adaptation, surface integrity, voids and excess adhesive material. Methods: Forty extracted human mandibular molars were prepared with standardized proximal cavities 2–3 mm below the cementoenamel junction (CEJ) and randomly assigned to two groups (n = 20 each). Group 1 received DME with the modified matrix technique; Group 2 was treated with the R2T. In both groups, a flowable bulk-fill composite was applied. Surface characteristics and marginal adaptation were evaluated using scanning electron microscopy (SEM) and laser profilometry. Qualitative scoring and quantitative measurements were performed. Statistical analysis was conducted using GraphPad Prism (version 10.02.0). Results: The modified matrix technique resulted in significantly smoother composite surfaces (p < 0.001), whereas the R2T showed significantly fewer voids, better marginal adaptation, and less excess bonding material (p < 0.05). No statistically significant difference was observed in surface integrity between the groups. Conclusions: While the MMT produced smoother surfaces, the R2T resulted in superior marginal quality with fewer voids and less excess adhesive material. The findings suggest technique-specific advantages rather than overall superiority, indicating that both approaches appear feasible. Clinical decision-making should be guided by anatomical and operator-related factors.
Keywords: deep margin elevation; proximal box elevation; restorative dentistry; supracrestal connective tissue attachment; dentogingival complex; periodontology deep margin elevation; proximal box elevation; restorative dentistry; supracrestal connective tissue attachment; dentogingival complex; periodontology
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MDPI and ACS Style

Cores Ziskoven, P.; Vogel, D.; Schumann, S.; Kiramira, D.; Nguyen, T.; Geyer, A.M.; Weusmann, J.; Deschner, J. The Perio-Resto Interface: In Vitro Comparison of Two Deep Margin Elevation Techniques on Surface Roughness, Marginal Adaptation and Material Integrity. Dent. J. 2026, 14, 161. https://doi.org/10.3390/dj14030161

AMA Style

Cores Ziskoven P, Vogel D, Schumann S, Kiramira D, Nguyen T, Geyer AM, Weusmann J, Deschner J. The Perio-Resto Interface: In Vitro Comparison of Two Deep Margin Elevation Techniques on Surface Roughness, Marginal Adaptation and Material Integrity. Dentistry Journal. 2026; 14(3):161. https://doi.org/10.3390/dj14030161

Chicago/Turabian Style

Cores Ziskoven, Pablo, Dorothea Vogel, Sven Schumann, David Kiramira, Thanya Nguyen, Andreas M. Geyer, Jens Weusmann, and James Deschner. 2026. "The Perio-Resto Interface: In Vitro Comparison of Two Deep Margin Elevation Techniques on Surface Roughness, Marginal Adaptation and Material Integrity" Dentistry Journal 14, no. 3: 161. https://doi.org/10.3390/dj14030161

APA Style

Cores Ziskoven, P., Vogel, D., Schumann, S., Kiramira, D., Nguyen, T., Geyer, A. M., Weusmann, J., & Deschner, J. (2026). The Perio-Resto Interface: In Vitro Comparison of Two Deep Margin Elevation Techniques on Surface Roughness, Marginal Adaptation and Material Integrity. Dentistry Journal, 14(3), 161. https://doi.org/10.3390/dj14030161

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