MANAGEMENT OF MIDLINE DIASTEMA
MANAGEMENT OF MIDLINE DIASTEMAPresented by:Dr. Hitesh
ChopraConsultant Cosmetic Surgeon and Endodontist
1CONTENTS,,INTRODUCTIONETIOLOGYDIAGNOSISMANAGEMENTCONCLUSIONREFERENCESREMOVAL
OF CAUSEACTIVE TREATMENTRETENTIONINTRODUCTION
The term midline diastema refers to any spacing or gaps existing
in midline of the dental arch.It is generally used in reference to
maxillary arch,even tough midline spacing is present in the
mandibular arch.Maxillary midline diastema are one of the most
common problems encountered.It has been defined as a space greater
than 0.5 mm between proximal surfaces of adjacent teethIt is easy
to treat but difficult to retain. 4 ETIOLOGY5Main etiological
factors are:-TRANSIENT MALOCCLUSIONTOOTH MATERIAL-ARCH LENGTH
DESCREPENCY ABNORMAL FRENAL ATTACHMENTPRESSURE HABITSMIDLINE
PATHOLOGYIATROGENICRACIAL PREDISPOSITIONDIAGNOSISThe proper history
and clinical examination should be done .
Measure the mesiodistal width of the teeth which will help in
determining the tooth material arch length discrepancies.
BLANCH TEST- lift the upper lip and pull in outward and look for
blanching of the soft tissue lingual to and between two central
incisors. presence of blanch indicates high frenal attachment as
cause of midline diastema.
4. Check for any oral habit.
5. Periapical radiograph- presence of nothing in interdental
bone is a diagnostic of a thick and fleshy
frenum.MANAGEMENTMANAGEMENT OF MIDLINE DIASTEMA CAN BE DONE IN
THREE PHASES:-First phase involves the removal of etiology.Habbit
should be eliminated using fixes or removal habit breakersDiastema
due to ugly duckling stage -no treatment requiredDiastema due to
imperfect fusion at midline-excision of included interdental tissue
between the incisors. a flap is raised interdentally and fissure
inserted gently into the cleft.with the bur the included tissue are
removed and flap situated.121. REMOVAL OF CAUSEEsthetic
Rehabilitation2. TreatmentACTIVE TxRemoval appliancesPASSIVE
TxFixed applianceMost orthodontist recomends long term retention
using suitable retainers since midline diastema is considered as
easy to treat but difficult to retain Prolonged retention is
indicated in lingual bonded retainer3. RETENTIONEsthetic composite
resins generally used to close midline diastema specially in adult
patients.
it requires a gradual composite build up on the mesial surface
and stripping of distal surface of central incisors and lateral
incisors in order to achieve a natural shape and size of the
teeth.ROLE OF COSMETIC RESTORATION
Presence of peg shaped lateral or teeth with other anomalies of
shape and size require prosthetic rehabilitation. missing teeth
should be replaced with fixed or removable prosthesis.PROSTHESIS OR
CROWNTHUS THE TREATMENT OF MIDLINE DIASTEMA WILL IMPROVE THE
ESTHETICS OF THE PERSONIT WILL HELP IN NORMAL ALIGNMENT OF TEETH
WHICH WILL CONTRIBUTE TO THE ORAL HEALTH BUT ALSO GOES A LONG WAY
IN THE OVERALL WELL BEING AND PERSONALITY OF AN
INDIVIDUAL.CONCLUSIONContemporary orthodontics-4th
edition-by:-William R Proffit,Henry W.Fields,David
M.SarverOrthodontics current principle techniques-4th
edition-by:-Thomas M. Graber,Robert L. Vanarsdall,Katherine
W.L.Orthodontics The Art and Science-4th edition
by:-S.I.BhalajiTextbook of Orthodontics-2nd edition-by:-Gurkeerat
singh
REFERENCES THANK YOU
