Diastema: It is defined as the distance between two adjacent teeth.

Midline Diastema is defined as the anterior midline spacing between the two central incisors.

Maxillary Midline Diastema:

It is defined as a space greater than 0.5 mm between the proximal surfaces of adjacent teeth.

Causes of Midline Diastema:

• Normal developing dentition
• Tooth material deficiency
• Physical Impediment
• Habits
• Artificial Causes
• Racial Predisposition

DIAGNOSIS

• A 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 tissues lingual to and between two central incisors. The presence of blanch indicates high frenal attachment as the cause of midline diastema.
• Check for any pernicious oral habits.
• Periapical radiograph:- presence of notching in the interdental bone is a diagnostic of a thick and fleshy frenum.
• Midline radiographs will help in diagnosing midline pathology.

The management of midline diastema involves the removal of the cause, active treatment, and retention.

New Approach to Midline Diastema Closure:

The Role of Cosmetic Restoration:

• Esthetic composite resins are used to close midline diastema, especially in adult patients.
• It requires gradual composite build-up on the mesial surface and stripping of the distal surfaces of the central and laterals to achieve a natural shape and size of the teeth.

Prosthesis/Crown:

• The presence of peg-shaped laterals or teeth with other anomalies of shape and size requires prosthetic rehabilitation.
• Missing teeth should be replaced with a fixed or removable prosthesis.

The treatment of midline diastema closure will improve the esthetics of the person and help with the normal alignment of teeth, which will not only contribute to oral health but also go a long way toward the overall well-being and personality of an individual.

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