Midline diastemata or diastemas occur in approximately 98% of 6 year olds, 49% of 11 year olds and 7% of 1218 year olds1. Treatment options for the significant dental midline diastema michael r. Esthetic closure of diastema by porcelain laminate veneers. The midline diastema was very wide mm in younger children 7 to 11 months, decreased in children up to age 4, and presented a mild increase in children between 5 and 6 years of age table 4. Correct cause should be diagnosed and proper treatment should be rendered accordingly. Online services clinical exam electronic submission. Spontaneous closure of midline diastema following frenectomy. This type of fibrous attachment can prevent the two maxillary central incisors from approximating each other. After 3 months later, interdental space was filled with interdental papilla figure 6c. Discussion diastema closure with direct resin is a recommended procedure, which is frequently. This case report presents the interceptive orthodontic treatment of a 9year, 5monthold boy with class i malocclusion, a 9.
Are diastemas normal and when should i consider diastema. Weber lists the causes for spacing between maxillary incisors as the result of high frenum attachment, microdontia, macro gnathia, supernumerary teeth, peg. A lot of treatment options have been proposed to close the space between maxillary anterior teeth. Diastema closure, direct resin, customized matrix introduction.
Longterm bonded retention after closure of maxillary midline diastema. Closure of midline diastema through combined surgical and removable orthodontic approach deepak chauhan 1, bimal kirtaniya 2, avantika tuli 2, tripti chauhan 3 1 department of pedodontics and preventive dentistry, h. Another common cause of diastema is a high attached labial frenum. Ocurrence of midline diastema among children of different. Treating the midline diastema is a matter of concern for practitioners, as many different aetiologies are reported to be asso. Midline diastema can be physiological, dentoalveolar, due to a missing tooth, due to peg lateral, midline supernumerary teeth, proclination of the upper labial segment, prominent frenum or due. Aim the aim of this study was to evaluate spontaneous closure of the interincisive diastema in a group of patients, using a new surgical technique for the treatment of upper lip frenulum hypertrophy. Make sure to polymerize the facial for 20 seconds before moving to the lingual surface.
A diastema is a space gap between two teeth, most often noticeable between the two front teeth. Diastema closure composite techniques photo galleries. Midline diastema is enormously valued in nigerian society as 29. Orthodontic treatment of a midline diastema two reasons.
Management of midline diastema linkedin slideshare. Diastema size and type of upper lip midline frenulum. Midline diastema can be physiological, dentoalveolar, due to a missing results. Neeta ghimire 1, iccha kumar maharjan 2, nisha mahato 3, nisha ghimire 4, pankaj nepal 5 1 department of pedodontics and preventive dentistry, college of dental sciences, chitwan medical college teaching hospital, bharatpur, nepal. Discrete gingival enlargement resulting from artificially. This condition usually occurs when there is a disproportionate relationship between the jaw and the size of the teeth, but can also be caused by alignment problems, protruding teeth, or oversized tissue. The continuing presence of a diastema between the maxillary central incisors in adults often is considered an esthetic or malocclusion prob lem. The presence of a midline diastema usually distorts a pleasing smile. Diagnostic orthodontic plaster models of 102 patients with permanent dentition were studied. Diastema closure using direct bonding restorations. Midline diastema between maxillary central incisors is a common occurrence, especially in primary and mixed dentition.
One of the main causes of diastema is enlarged upper lip frenulum attachment. Diastema closure in central incisors can be successfully accomplished using direct adhesive restorations and gingival recontouring figures 6a, 6b, 7. Orthodontic treatment of a midline diastema related to. The midline diastema is a space or gap greater than 0. Midline diastemas require proper diagnosis and timing for better care of patients. When located in the maxillary central incisor region a supernumerary tooth is called mesiodens and its prevalence has been estimated to be 0. However, several factors can cause a diastema that may require. Orthodontic management of midline diastema in mixed dentition. If this tissue is short and too tight, it can result in the diastema. However, the etiology of diastema is complex and multifactorial.
Midline diastema, which occurs as spacing between the upper central incisors, is a common occurrence seen in the pediatric population. A putty matrixreduction guide is in place on this waxup. Midline diastema closure with directbonding restorations epaper. The treatment objective was completely achieved in 5 months with the habit discontinued and the open bite closure showing the efficacy and efficiency of the approach undertaken. Government dental college, shimla, himachal pradesh, india 2 department of pedodontics and preventive dentistry, himachal dental college, sunder nagar, himachal pradesh. Midline diastema closure with partial laminate veneers. The midline diastema is a space between the maxillary central incisors.
European journal of paediatric dentistry 32001 1 management of midline diastema using a new surgical technique i. From the beginning of time people have noticed, and perhaps passed judgment on, people with prominent spaces in their dentitions. Diastemata are common for children and can exist in adult teeth as well. There are wide variations of perception of midline diastema among different cultures. Several methods to eliminate ectopic frenal attachments have been suggested, including frenectomy elimination and frenotomy repositioning. Treatment options for the significant dental midline diastema. Clinical evaluation of direct composite restoration done. The treatment goals were to decrease the magnitude of the diastema and to simulate the characteristics of the ugly duckling stage. People with midline diastema may be selfconscious about having a space between their teeth. Management of midline diastema using a new surgical.
Diastema closure cosmedent, inc 401 n michigan ave. Supernumerary teeth are teeth in excess of the normal number 2. Home about us subject areas contacts advanced search help. Composite buttons for relapsed spaces, singletooth. Esthetic enhancement with diastema closurea case report. Orthodontic treatment of midline diastema related to. A stepbystep discussion of materials utilized and specific techniques are outlined in detail. Introduction a space between adjacent teeth is called a diastema. Enter case report data to this work file at your convenience. This is a temporary file and hence do not link it from a website, instead link the url of this page if you wish to link the pdf file.
Start your diastema closure with facial application first because this will make it easier for you to set up the midline. Midline diastema causes and treatment options omilights. A 20 year old female patient was referred from the department of orthodontics for frenectomy. Midline diastema is common dental anomaly having multiple the continuing presence of a diastema between the maxillary central incisors in adults often is considered an esthetic or malocclusion prob lem. Feb 16, 2011 c abnormal labial frenum the presence of a thick and fleshy labial frenum can cause a midline diastema. The size and shape of the patients teeth would be changed in the final restorations. Pdf maxillary midline diastema is a common esthetic problem in. Pdf maxillary midline diastema is a common esthetic problem in mixed and permanent dentition. It occurs more frequently in the median plane of the maxillary arch between the two central incisors and hence called the median, central or midline diastema. Changes in quality of life during orthodontic correction. In the year prior to your intended clinical exam, register for the exam and you will be informed when the electronic submission site is available. Creath, dmd, ms t he continuing presence of a diastema between the maxillary central incisors in adults often is considered an esthetic or malocclusion problem.
A midline diastema usually is part of normal dental development during the mixed dentition. Many species of mammals have diastemata as a normal feature, most commonly between the incisors and molars. Differential diagnosis and combined treatment of maxillary midline. This trihelix spring is a simple, effective, aesthetic and biologically compatible device with excellent root control for the treatment of midline diastema. The presence of diastema in the ante rior esthetic zone can be displeasing to a personas smile and many patients are motivated to improve their appearance either restoratively with composite resin bonding, veneers, crowns, or orthodontic treatment. The space can be a normal growth characteristic during the. Diastemata are primarily caused by imbalance in the relationship between the jaw and the size of teeth.
It has both aesthetic and psychological role on patients personality. The teeth on either side of a space are called dents du bonheur or lucky teeth in france. Ronald goldsteins lectures on the nuances that must be taken into consideration when clinicians attempt to close a midline diastema. Various treatment options are available for treatment of mmd. On examination there was midline diastema with papillary frenum attachment figure 3a.
The aim of the study was to assess frenulum attachment in patients with diastema and investigate if type of upper lip frenulum attachment has an impact on the width of diastema. Government dental college, shimla, himachal pradesh, india 2 department of pedodontics and preventive dentistry, himachal dental college, sunder nagar, himachal pradesh, india 3. The most often is maxillary midline diastema between upper central incisors. Composite restorations, diastema, direct composites, midline diastema diastema is defined that spaces more than 0. Midline diastema due to simultaneous interplay of mesiodens and thumbsucking habit is a very uncommon situation and can represent negative. Closure of midline diastema by direct composite resin. Although physiologic transitory maxillary midline diastema is observed in children during eruption of maxillary anterior teeth in most cases, it is. During rapid maxillary expansion and it indicates the opening of intermaxillary suture with rapid expansion at the rate of 0. Figure 6 photograph illustrating how a diagnostic waxup is used to demonstrate how a patients smile would be changed. The patient was followed up for a period of 4 months, at the end a remarkable improvement in the aesthetics was observed, due to spontaneous closure of midline diastema.
Maxillary midline diastema is more common than mandibular midline diastema. From a purely cosmetic standpoint, value of the appearance of ones teeth has taken on a greater importance in todays society. Maxillary midline diastema is a common aesthetic complaint of patients. Composite buttons for relapsed spaces, singletooth crossbite, and midline diastema. Midline diastema refers to space or gap between two central incisors. Conservative and orthodontic management of maxillary. The midline diastema of the teeth is often a normal or developmental.
When the midline diastema is not characteristic of the. Width of dental arches in patients with maxillary midline. Midline diastema closure using silicone guide can provide precise results according to the analysis, either on the anatomy of the palatal, labial and dental midline. Management of midline diastema using a new surgical technique. This lecture includes a discussion on tooth shape and proportion. Then fill in the lingual aspect of the tooth again with a microfill composite. Midline diastema is common dental anomaly having multiple the continuing presence of a diastema between the maxillary central incisors in adults often is considered an esthetic or malocclusion prob. Maxillary midline diastema mmd is a common problem patient report to a dental clinic. Closure of midline diastema through combined surgical and. Discussion a diastema is a space or gap, most often seen between the two upper front teeth. The use of nanofiller composite resins at the closure of midline diastemic can provide advantages of both strength and maximum polishing results.
The labial frenum is found at the mid line inside the upper lip, and it is a flap of mucosa and connective tissue that holds the upper lip close to the teeth. Braces were placed on the first molars and the maxillary central. In france, the teeth on either side of a space or gap are called dents du bonheur or lucky teeth. Most literature references to date promote the concept that maxillary midline diastema is of multifactorial etiology, considering only environmental factors. A diastema plural diastemata is a space or gap between two teeth.