Effect of deep margin elevation with different base materials on periodontal health in a clinical study

This prospective clinical investigation evaluated the effects of proximal box elevation using three base materials on periodontal tissues in premolar teeth treated with direct composite restorations. In endodontically treated maxillary premolars, gingival crevicular fluid (GCF) samples were collected after restoring cavities using three base materials: resin-modified glass ionomer (RMGI), flowable composite (Tetric N-Flow), and injectable hybrid composite (Beautifil Flow Plus). Periodontal health was assessed by measuring interleukin-1 (IL-1) and tumor necrosis factor (TNF) concentrations, bleeding on probing (BOP), and pocket depth (PD) immediately and at 3 months postoperatively. Data were statistically analyzed using one-way ANOVA to compare groups, Levene's test to assess homogeneity of variances, and paired t-tests and chi-square tests were used to assess differences within groups. the results revealed that the levels of IL-1, TNF, and PD differed significantly among the three base materials at different time points. The Beautifil Flow Plus group showed the highest TNF levels, the most substantial absolute reduction, and the lowest reduction in IL-1 levels. However, there were no significant differences in BOP among the three materials at any time interval. Within the limitations of this three-month study, all materials were clinically acceptable, though Tetric N-Flow and RM-GI showed a more favorable short-term inflammatory profile than Beautifil Flow Plus. However, due to the limited sample size and short follow-up, no definitive claims regarding long-term periodontal compatibility or clinical superiority can be made.