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Senior Lecturer, Department of Conservative Dentistry and Endodontics, Institute of Dental Studies and Technologies, Modinagar, Ghaziabad, Uttar Pradesh, India
Today's dentistry is dominated by restorative procedures which are carried out to meet the demands of not only function but also aesthetics. Prosthetic and restorative therapies generally require a healthy periodontium as a prerequisite for successful treatment outcome. A mouth with a healthy periodontium may be affected by restorations of poor quality, and restorations of the highest quality may fail in a mouth with periodontal disease. This is the first of two articles that attempt to explain the concept of the complex question of biologic width and the problems that occur after improper margin placement in the periodontium. Initially, the dimensions of biologic width are considered and then margin placement and reasons for restorative procedures are discussed. This article also addresses the interactions between periodontal tissues and restorative procedures.
Clinical Relevance: Understanding the impact of restorative procedures on periodontal health in regular dental examination by dentists can help in early diagnosis and treatment of periodontal diseases. This could prevent further progression of disease and reduce the frequency of tooth loss.
Article
Periodontal tissues form a strong basis for both aesthetics and comfort of the dentition as well as the functioning of dental tissues.1 The interrelationship of restorative dentistry and periodontics is a dynamic one.2 The periodontal health at the restorative gingival interface represents a big challenge for the restorative dentist, as the tooth and its surrounding structures are continuously being affected by microbial flora, and restorative dentistry may aggravate this condition.3
Prosthetic and restorative treatments generally require a healthy periodontium as a prerequisite for successful outcome, and this interaction between two important fields of dentistry is present on many fronts, including placement of restorative and crown margins, and contours of the crown, and the response of the gingival tissues to restorative preparations.1
Periodontal attachment loss begins when the epithelial integrity of the dentogingival unit is breached by microbial flora, trauma, or both. The progression of the periodontal destruction appears to be related to host susceptibiity, competence of the surrounding tissues, and virulence factors of bacterial pathogens,4,5 which in turn may be influenced by the three main aspects of a dental restoration: morphology, margin quality and margin location.3
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