In
endodontics class at AHEAD Academy, New Delhi, midline diastema closure was
discussed. The steps were explained in detail to the students. They were
motivated to practice on more number of patients. The midline diastema is a
space (or gap) between the maxillary central incisors. The space can be a
normal growth characteristic during the primary and mixed dentition and
generally is closed by the time the maxillary canines erupt. A midline diastema
usually is part of normal dental development during the mixed dentition.
However, several factors can cause a diastema that may require intervention. An
enlarged labial frenum has been blamed for most persistent diastemas, but its
etiologic role now is understood to represent only a small proportion of cases.
Other etiologies associated with diastemas include oral habits, muscular
imbalances, Physical impediments, abnormal maxillary arch structure, and
various dental anomalies. Effective diastema treatment requires correct
diagnosis of its etiology and intervention relevant to the specific etiology.
Correct diagnosis includes medical and dental histories, radiographic and
clinical examinations, and possibly tooth-size evaluations. Appropriate treatment
modalities have been described. Timing often is important to achieve
satisfactory results. Removal of the etiologic agent usually can be initiated
upon diagnosis and after sufficient development of the central incisors. Tooth
movement usually is deferred until eruption of the permanent canines, but can
begin early in certain cases with very large diastema.
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