Periodontal Tissue Response to Crown Margin Placement: A Comparative Evaluation of Prosthodontic Designs

European Journal of Prosthodontics and Restorative Dentistry (2025) 33, 465-470

Dr. Shruti Karvekar1* , Dr. Saranya Aathilingaperumal 2 Dr. Vani Sarada3 Dr. Sunpreet Kaur4 , Dr. Mudita Chaturvedi5 Dr. Abhijit singh6

Periodontal Tissue Response to Crown Margin Placement: A Comparative Evaluation of Prosthodontic Designs

Address for Correspondence

Crown margin placement, Periodontal tissue response, Prosthodontic design, Emergence profile, Restorative material, Gingival health.

Dr. Shruti Karvekar1*
Email- shruti.karvekar@gmail.com

KAHER'S KLE VK INSTITUTE OF DENTAL SCIENCES
READER
Department- Department
of PeriodontologyORCID ID- https://
orcod/0000000336709540 Email- shruti.
karvekar@gmail.com
1*

Resident periodontist - final year, Dept of
Periodontology, Sree Balaji Dental College & Hospital, Pallikaranai – 600100 Email
i
d: saranyatheoder@gmail.com ORCID iD:
0009000028529780
2

Faculty, Kristiu Jayanti Institute of Management
Kristu Jayanti University
K Narayanapura,
Bengaluru Email: sarada889@yahoo.in
3

Reader SGT Dental College, Hospital and Research
Institute, Gurugram Orcid ID : 0000000338631214
Mail ID : sunpreet.kaur26@gmail.com

This comprehensive review examines the influence of crown margin placement and
prosthodontic design on periodontal tissue response, emphasizing the biological
principles that govern longterm restorative success. The periodontal tissues are highly sensitive to restorative interventions, and their stability depends on respect for the
natural soft tissue attachment and the careful positioning of restoration margins. Evidence consistently shows that supragingival margin placement offers the most favorable clinical outcomes due to reduced plaque accumulation, greater accessibility
for oral hygiene, and minimal disruption to gingival architecture. Equigingival margins may also perform satisfactorily when precisely adapted, while subgingival margins remain useful for esthetic and structural purposes but carry a greater risk of inflammation and loss of attachment. Prosthodontic factors such as margin geometry,
emergence profile, restorative material, and fabrication technique further influence
periodontal behavior by affecting surface smoothness, bacterial adhesion, and soft
tissue compatibility. Integrating digital technologies, minimally invasive restorative
approaches, and biologically driven preparation concepts enhances marginal accuracy and supports periodontal preservation. The findings reinforce the importance
of individualized treatment planning based on tissue phenotype, esthetic requirements, and clinical needs to achieve optimal functional and periodontal outcomes.

4

BDS, MDS, PhD Department of Dental Research
Cell, Dr. D. Y. Patil Dental College and Hospital, Dr. D.
Y. Patil Vidyapeeth, Pimpri, Pune, India. ORCID- 00
0
0000341922514 drmudita@hotmail.com
5

6
Senior resident, Department of Prosthodontics
and Crown and Bridge, Sri Guru Ram Das Institute
of Dental Sciences and Research, Amritsar Orcid id
0009000865775719 abhijitsingh978@gmail.com

Received: 11.05.2025
Accepted: 27.08.2025

Received: 11.05.2025

10.1922/EJPRD_2865
Accepted:
27.08.2025 Karvekar18

1. INTRODUCTION

The interrelationship between prosthodontic restorations and periodontal health has
long been recognized as a critical determinant of longterm clinical success. Restorative
margins that encroach upon or disrupt periodontal tissues can lead to inflammation,
attachment loss, and structural instability, whereas welldesigned restorations enhance
function while preserving softtissue equilibrium. The periodontal tissues comprising
the gingiva, periodontal ligament, cementum, and alveolar bone are highly responsive
to restorative interventions, and even minor deviations in margin placement or contour
can initiate pathological changes. This sensitivity is particularly evident around the
supracrestal tissue attachment (STA), previously termed “biologic width,” which
represents the physiological dimension required for softtissue stability and is a pivotal
reference point in restorative dentistry. Contemporary evidence underscores that any
restorative margin violating this dimension risks provoking chronic inflammation,
gingival recession, or bone resorption, thereby compromising both periodontal and
prosthodontic prognosis1 .
The biological concept of STA has undergone refinement in recent years, emphasizing
its structural composition and functional significance in restorative planning.
Supracrestal tissue attachment must remain undisturbed to maintain periodontal
health, and clinicians must understand its dimensions and variability across individuals.
Updated literature highlights that restorative procedures must respect this anatomical
requirement and avoid subgingival intrusion unless clinically justified. Deviations from
this principle can jeopardize soft tissue integrity and esthetic outcomes, particularly in
the anterior region where marginal discrepancies are more visible and biologically
consequential2 . Similarly, management strategies such as crown lengthening have been
explored to reestablish an adequate STA when restorative requirements mandate
deeper margin placement. Crown lengthening facilitates the placement of margins
without biologic width violation; however, its indications, limitations, and esthetic
implications must be carefully weighed in clinical decisionmaking3 .
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EJPRD