Diastema
What is diastema?
Space or gaps between two teeth mostly occur in anterior segment of teeth.
Causes of diastema
- Undersized teeth in larger jaw.
- Very large labial frenum that causes midline diastema(Gap between two maxillary central incisors)
- Habits such as lip biting (mostly lower lip), thumb sucking, tongue thrusting.
- Supernumerary teeth and heredity
- Large tongue that may push the teeth forward.
- Periodontal disease
Management of diastema:
- Disatema can be corrected surgically, orthodontically and conservatively.
- Mild to moderate diastema can be corrected conservatively withcomposite restoration
- Very larger diastema will require orthodontic treatment
- It can be corrected with veneers and crowns
Treatment:
- Removal of the cause if the cause is abnormal labial frenum then it should be removed surgically
- Shade selection.
- Isolation with cotton rolls
- Roughening of enamel surface with diamond bur
- Acid etching of enamel surface with phosphoric acid for 30seconds
- Washing and drying
- Application of bonding agent and curing for 20seconds
- Composite restoration is applied then mylar strip is placedproximally and held with thumb and forefinger facially and linguallyfor better contouring and cured for 40 seconds
- After polymerization remove the strip
- Finishing and polishing with carbide finishing burs and abrasive discs.
Additional resources
A step-by-step approach to a diastema closure
http://www.moderndentistrymedia.com/
A restorative approach to diastema closure
http://lindagreenwall.co.uk/
Managing a Diastema Case with Porcelain Veneers
http://drgoldsteinspeaks.com/