The present study will evaluate and compare the effect of functional CL and DME in the treatment of posterior teeth with class II caries clinically and on the level of TNF-α in the GCF of treated teeth.
Clinical evaluation of periodontal tissue in the form of probing depth as a primary outcome, clinical attachment level, plaque index, bleeding index, gingival index, pink aesthetic score, Radiographic evaluation of biological width and the level of TNF-α in the GCF as a secondary outcome.
Patients aged 20-50 years
Both genders
Patients free from any systemic disease that may affect the treatment (Greenberg & Glick, 2012)
Patients with intact periodontium
Pregnant and lactating females
Smokers
Drug abusers.
Patients with persistent poor oral hygiene
Parallel
Functional Crown lengthening
Procedure/Surgerypatients will undergo functional crown lengthening by raising a full thickness flap with osseous resection to establish a distance of 3 mm between the cervical margin of the cavity and the bone crest. Osteoplasty was performed in the adjacent and neighboring tooth surfaces to accomplish a smooth bone contour. The flaps will then be sutured in their new position
Deep Margin Elevation
Procedure/Surgerypatients will undergo deep margin elevation through a two-step direct restoration performed using the concepts of Progressive Matrixing and Wedging where the Deep subgingival cavity margin will be acquired. Then isolation by rubber dam. A curved matrix will seal the margin without any gingival or rubber dam entrapped in between. One step adhesive system will be performed under rubber dam isolation. Composite resin base is applied to raise the margin by about 2 mm. A bulk fill packable or flowable composite can be used. Finishing will be done using polishing strips and disks. Finally a bitewing radiograph will be taken to check the presence of overhangs or gaps before the final restoration.
Probing depth
Will be measured from the gingival margin to the depth of the pocket at four points (mesio-facial, mid-facial, disto-facial and mid-lingual) to the nearest millimeter using UNC-15 periodontal probe. The average of the three facial points will be recorded as the facial probing depth (FPD), while the mid-lingual point will be recorded as the lingual probing depth.
Biochemical evaluation
GCF samples will be collected to measure the level of TNF-α in treated teeth. Before sampling, the adjacent teeth will be isolated with cotton rolls. Crevicular fluid will be collected on perio paper strips placed parallel to the long axis of the tooth of concern in the gingival sulcus until mild resistance is felt and kept for 30 seconds and pooled in reduced transport fluid (RTF) medium for biochemical analysis. GCF collected samples contaminated with blood and saliva will be discarded
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