15 September 2020

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Closing diastemas: a clinical case

Allegra Comba

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In modern society, the aesthetics of the smile plays a fundamental role and the presence of dental diastemas can represent, for the patient, an aesthetic and functional problem requiring the  intervention by the dentist.
Dental diastemas are quite common and are more frequently found between the teeth of the anterior sector. They may be due to occlusal factors, the presence of a hypertrophic labial frenulum, dento-alveolar discrepancies, periodontal disease, flawed habits or iatrogenic factors. There are several therapeutic approaches for closure of diastemas in the anterior sector and each individual case requires careful planning. In selected cases, the development of increasingly high-performance adhesive systems and composite resins with high mechanical and biomimetic properties have allowed the clinician to obtain optimal and long lasting results even with direct restorative techniques. The use of composite resins, in fact, allows a minimally invasive, economic and predictable treatment over time.

The illustrated clinical case (Figures 1-10) concerns the aesthetic resolution of a diastema between the anterior central elements with direct technique in a young girl with physiological occlusion and I molar and canine class.

Figure 1: Initial situation

Fig 2: Wax-up to simulate the direct composite restorations

Fig 3: Dental dam isolation of the field

Fig 4: Silicon index to guide the direct composite reconstruction

Fig 5: Etching of enamel for 30 sec

Fig 6: Adhesive application

Fig 7:  Palatal and interproximal wall

Fig 8: Final restorations under dental dam

Fig 9: Final restorations after 1 month

Fig 10: X-ray examination