The management of deep subgingival carious lesions presents significant challenges for achieving durable adhesive restorations due to limited access, moisture control, and proximity to periodontal tissues. Two main approaches are currently adopted to manage these cases: Deep Margin Elevation (DME) and Surgical Crown Lengthening (SCL). This systematic review (PROSPERO registration CRD420250654262) aimed to compare the performance and survival of restorations placed following DME versus SCL in teeth with deep subgingival margins. A comprehensive literature search was conducted in PubMed, B-ON, and the Cochrane Library for studies published between 2014 and 2025. Following PRISMA guidelines, six studies were included. Methodological quality and risk of bias were assessed using ROBINS-I, RoB 2, and the CARE guidelines. The available evidence indicates that both DME and SCL provide satisfactory periodontal stability, high restoration survival rates, and a low incidence of recurrent caries. DME emerged as a minimally invasive strategy that facilitates adhesive procedures by relocating deep margins to more accessible positions, potentially improving marginal integrity while preserving tooth structure and gingival architecture, particularly in patients with a thick gingival biotype. The choice between DME and SCL should be individualized. Further long-term clinical studies are required to clarify their impact on adhesive interface durability in subgingival environments.

Background/Objectives: Interincisive midline deviation is frequent. Determining the cause (dental versus skeletal) is crucial for treatment planning. This study assessed the null hypothesis that neither clinical midline shift nor temporomandibular disorder (TMD)-affected side correlate with maxillary/mandibular asymmetry. Methods: Tomographic images were acquired using the i-CAT Imaging System; mandibular/maxillary measurements were obtained with the Planmeca Romexis software. This is an ancillary study of a clinical trial (NCT02144233) that included chronic pain (TMD diagnosis; DC/TMD criteria), fully dentate and stable normo-occlusion participants. Results: Thirty-eight CBCT scans were analyzed: 35 (92.1%) females, 3 (7.9%) males. Mean age 34.6 (11.9) years old. Sixteen (42.1%) midline deviations to the right and 13 (34.2%) to the left. In the study population the right side was more developed: hemimandible length 119.4 (5.7) mm versus 118.6 (5.3) mm, right and left sides, respectively (95% CI 0.21 to 1.51), p=0.01. Conclusions: Neither midline shift side nor affected side predicted a less developed hemimandible.

Background/Objectives: Interincisive midline deviation is frequent. Determining the cause (dental versus skeletal) is crucial for treatment planning. This study assessed the null hypothesis that neither clinical dental midline shift nor the temporomandibular disorder (TMD)-affected side correlate with maxillary/mandibular asymmetry. Methods: Thirty-eight CBCT scans were analyzed: thirty-five (92.1%) females, three (7.9%) males; mean (SD) age 34.6 (11.9) years old. Tomographic images were acquired using the i-CAT^® Imaging System; mandibular/maxillary measurements were obtained with the Planmeca Romexis^® software v.6.This is an ancillary study of a clinical trial (NCT02144233) that included chronic pain (TMD diagnosis; DC/TMD criteria), fully dentate, and stable normo-occlusion participants. Results: We found sixteen (42.1%) dental midline deviations to the right and thirteen (34.2%) to the left. In the study population, the right side was more developed: a hemimandible length of 119.4 (5.7) mm versus 118.6 (5.3) mm for the right and left sides, respectively (95% CI 0.21 to 1.51), p = 0.01. Conclusions: Neither the dental midline shift side nor the affected side predicted a less developed hemimandible.