1. Diastema Closure (Gonzalez)

Define Diastema

ADA definition is a space between two adjacent teeth in the same dental arch

What are the 3 main reasons why people seek dental treatment?

Pain, Swelling and Esthetics

What are the main etiology of Diastema

• Labial frenum that is inserted too low

• Congenitally missing teeth

• Tooth loss

• Undersized (size discrepancy) or malformed teeth

• Supernumerary teeth

• Pathology cysts

• Oral habits such as tongue thrusting, frenum thrusting and thumb sucking

• Periodontal disease

What are the treatment options for Dieastema?

• Orthodontics

• Crowns

• Direct Resin Composite restoration

• Indirect Resin Composite Restorations

• Combinations of these

Advantages of Direct Resin Composite as Treatment for Diastema

• Reversible

• Conservative

• Good esthetics

• Immediate gratification

• Acceptable longevity

• Easy to Repair

• Lower cost

Diastema Closure Goals

• Create tooth form in harmony with adjacent teeth, adjacent gingival tissue, the rest of the arch and that follows facial form

• Keep stable occlusion

• Maintain good gingival health

What are the proportions of anterior teeth MD

Centra incisor= X

Lateral incisor = X-2mm

Canine = X-1mm

Maxillary central incisor proportions

• Width/Length

• MD width

• Length

• Width/Length: 75-85%

• MD width: 8.37-9.3mm

• Length: 10.4-11.2mm

What must you do before diastema exercise in sim lab to make sure your restorations are even?

Measure the width of the tooth before cutting it

Diastema Closure SIMLAB EXERCISE

1. Measure tooth dimensions

2. Make putty matrix

3. Cut 1.5mm from each mesial side of #8&9

4. Bevel scalloped margins with flame diamond burr to increase roughness

5. Etch, prime, bond first tooth

6. Create lingual shelf

7. Build up the tooth

8. Refine and polish before doing next too, even interproximally

9. Etch, prime bond the other tooth

10. Build lingual shelf

11. Build up tooth, make sure you have contact (use pull through method)

12. Refine and polish, mark anatomy