Periodontal health evaluation for deep margin elevation using bioactive composite versus bulk fill composite. A case report

Elevation of deep subgingival proximal cavity margins with resin composites under direct or indirect restorations was reported to be promising in terms of esthetic and mechanical points of view. A relatively new category of restorative materials called bioactive composites was released, until now, their periodontal response when used for elevating of deep subgingival margins have not been yet investigated. Thus, the aim of this report was to compare the periodontal conditions and radiographic marginal quality of two molars having their proximal dentin/cementum margins elevated with either bioactive composite or bulk fill composite. The patient had two proximal cavities with gingival margins below cemento-enamel junction in 26 and 27. 26 was vital and its proximal gingival margin was elevated using bioactive composite while 27 was non vital and its proximal gingival margin was elevated using flowable bulk fill composite before completing the endodontic treatment. The rest of the cavities of both teeth were completed with the same type of regular bulk fill composite. Four periodontal measurements, in addition to a radiographic evaluation for the gingival margins were recorded immediately after completing the restorative work and compared to the same measurements after 6 months. It could be concluded that, regardless of the poor radio opacity of the used bioactive composite, its use for elevation of dentin/cementum margin had a better periodontal response than using flowable bulk fill.