Abstract:

· Maxillary midline diastema (spacing) is a very common aesthetic problem. It has multifactorial etiology such as over attached labial frenulum, some habits such as finger sucking, tongue thrusting, or lip biting, dental malformations, genetics, dental/skeletal malformations, and imperfect coalescence of interdental septum.

· There are many solutions for diastema closure such as (braces, indirect restorations, direct composite restoration or surgical correction).

· The treatment of choice depends on each case and the etiology of diastema. When diastema results from an over attached labial frenum, the dentist may recommend a frenectomy. Older children and adults may then require braces or another treatment to close the gap but in younger children, the space may close on its own.

Introduction:

· When the etiology of the diastema is tooth-size disharmony, the restorative solutions is the treatment of choice. It could be direct or indirect restoration.

· The least invasive solution to restore diastema is direct composite restoration which could restore the aesthetic and function.

· In this article we will discuss how to restore a midline diastema with BIOCLEAR method with 4 years follow up.

Case scenario:

Fig.1

A middle age male patient presented to our clinic complaining of an aesthetic problem due to presence of midline diastema, after examinations and collecting data from the patient such as photographs, we decided to restore the diastema with BIOCLEAR method.

Fig.2

As we can see in Fig.1, the distal surfaces of the two upper central incisors need some adjustment, so we mark the area that will be adjusted with pencil using smile wheel as a guide.

Fig.3 & Fig.4

We use Elliot’s separator to separate the teeth, then we start to adjust the distal surface with finishing disc.

Fig.5

Now, the width is much better after adjusting with the disc.

Fig.6

Then the teeth were isolated with retraction cord and slightly roughened with air abrasion (Aqua care) to be ready for the next step.

Fig.7

Flowable composite was used for doing the first plane of the tooth that will help us in the final isolation and retraction of the tissues.

Fig.8

After finishing the first plane and removal of the retraction cord to apply final isolation.

Fig.9

The profile.

Fig.10

Isolation and retraction with aid of the first plane.

Fig.11

As we said before, we will restore the diastema with BIOCLEAR method so color coded matrix from the Black Triangle (BT) kit will be used (the color of the matrix is determined using the black triangle gauge).

Fig.12

The yellow matrix was the choice (depending on the black triangle gauge) then flowable composite was used to prevent the matrix’s movement during composite injection.