Multidisciplinary clinical decision-making of anterior diastema closure

Yu Haiyang, Shui Yusen, Jiang Qingsong

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West China Journal of Stomatology ›› 2024, Vol. 42 ›› Issue (3) : 277-285. DOI: 10.7518/hxkq.2024.2023460

Multidisciplinary clinical decision-making of anterior diastema closure

  • Yu Haiyang(), Shui Yusen, Jiang Qingsong
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Abstract

Anterior diastema is a common esthetic defect in China. The general treatment for a patient with diastemata, including orthodontics and direct and indirect restorations, is a multidisciplinary clinical procedure covering the orthodontics, operative dentistry, general dentistry, and prosthodontics department. Given the diversity of departments and the complex etiology of this defect, decision-making regarding the closing methods and time selection is undefined and unintegrated, which makes the long-term stability of closure unpredictable. This article proposed an etiology-based decision tree with actual measurement of diastemata width for diastemata closure. The decisional steps include classifying the etiological factors based on patients' medical history and clinical manifestation to evaluate the stability of diastemata. After maintaining the stability of diastemata, contemporary and multidisciplinary treatment plans were selected in accordance with the measured width of diastemata and patients' cosmetic psychology, economics, and available time. These decision trees focus on the challenges of collaboration among dental departments, propose an objective and efficient ways for connections, and promote efficient and effective diastemata closure.

Key words

anterior diastema / etiological diagnosis / clinical decision / multidisciplinary clinical procedure / actual measurement / adjacent laminate veneer

CLC number

R78

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Yu Haiyang, Shui Yusen, Jiang Qingsong. Multidisciplinary clinical decision-making of anterior diastema closure. West China Journal of Stomatology. 2024, 42(3): 277-285 https://doi.org/10.7518/hxkq.2024.2023460

References

1 杨鑫, 范晓川, 马琳莎, 等. 复合树脂层塑技术关闭前牙间隙的临床效果观察[J]. 口腔颌面修复学杂志, 2023, 24(4): 266-270.
1 Yang X, Fan XC, Ma LS, et al. Clinical observation of composite resin based on layers technique in closing anterior diastema[J]. Chin J Prosthodont, 2023, 24(4): 266-275.
2 Keene HJ. Distribution of diastemas in the dentition of man[J]. Am J Phys Anthropol, 1963, 21(4): 437-441.
3 Richardson ER, Malhotra SK, Henry M, et al. Biracial study of the maxillary midline diastema[J]. Angle Orthod, 1973, 43(4): 438-443.
4 Gelg?r IE, Karaman AI, Ercan E. Prevalence of malocclusion among adolescents in central Anatolia[J]. Eur J Dent, 2007, 1(3): 125-131.
5 Angle EH. Treatment of malocclusion of the teeth: Angle’s system[M]. Wilmington: White Dental Mfg Co., 1907.
6 Chaves PRB, Karam AM, Machado AW. Does the presence of maxillary midline diastema influence the perception of dentofacial esthetics in video analysis[J]. Angle Orthod, 2021, 91(1): 54-60.
7 Chen CT, Yang B, Yin YX, et al. Maxillary midline diastema closure with sectional feldspathic porcelain veneers: a case series followed 1 to 4?years[J]. J Esthet Restor Dent, 2023, 35(7): 1022-1029.
8 Vasques WF, Sá TA, Martins FV, et al. Composite resin CAD-CAM restorations for a midline diastema closure: a clinical report[J]. J Prosthet Dent, 2022, 127(2): 206-209.
9 Mattos CT, da Silva DL, Ruellas AC. Relapse of a maxillary median diastema: closure and permanent retention[J]. Am J Orthod Dentofacial Orthop, 2012, 141(1): e23-e27.
10 Abraham R, Kamath G. Midline diastema and its aetio-logy—a review[J]. Dent Update, 2014, 41(5): 457-460, 462-464.
11 陈扬熙. 口腔正畸学—基础、技术与临床[M]. 北京: 人民卫生出版社, 2012.
11 Chen YX. Orthodontics—foundation, technology and cli-nical[M]. Beijing: People’s Medical Publishing House, 2012.
12 Gkantidis N, Kolokitha OE, Topouzelis N. Management of maxillary midline diastema with emphasis on etiology[J]. J Clin Pediatr Dent, 2008, 32(4): 265-272.
13 Tadros S, Ben-Dov T, Catháin éó, et al. Association between superior labial frenum and maxillary midline diastema—a systematic review[J]. Int J Pediatr Otorhinolaryngol, 2022, 156: 111063.
14 Wolford LM. Orthodontics for orthognathic surgery[M]//Miloro M. Peterson’s principles of oral and maxillofacial surgery. Berlin: Springer, 2022: 1801-1824.
15 Huang WJ, Creath CJ. The midline diastema: a review of its etiology and treatment[J]. Pediatr Dent, 1995, 17(3): 171-179.
16 Dawson PE. Functional occlusion: from TMJ to smile design[M]. Amsterdam: Elsevier Health Sciences, 2006.
17 Tarnow DP, Magner AW, Fletcher P. The effect of the distance from the contact point to the crest of bone on the presence or absence of the interproximal dental papilla[J]. J Periodontol, 1992, 63(12): 995-996.
18 Wu JC, Zhu JK, Yang X, et al. Technique to restore the midline space of central incisors using a two-in-one template: a clinical report[J]. J Prosthodont, 2023, 32(5): 375-381.
19 Zhang Y, Zhang J, Fan L, et al. Closing post-orthodontic spaces between anterior teeth using sequential 3D-prin-ted direct composite injection guides[J]. Oper Dent, 2022, 47(6): 612-619.
20 王晓东, 赵克. 局部瓷贴面治疗上颌中线间隙的临床要点[J]. 中华口腔医学杂志, 2023, 58(5): 404-408.
20 Wang XD, Zhao K. Clinical application of sectional feldspathic porcelain veneers in maxillary midline diastema closure[J]. Chin J Stomatol, 2023, 58(5): 404-408.
21 于海洋, 赵俊颐, 孙蔓琳. 基于审美分析的口腔美容修复分类诊疗方案(一): 基本概念、决策树及临床路径[J]. 华西口腔医学杂志, 2024, 42(1): 19-27.
21 Yu HY, Zhao JY, Sun ML. Classified diagnosis and treatment scheme of oral cosmetic restoration based on aesthetic analysis (partⅠ): basic concept, decision tree and clinical pathway[J]. West China J Stomatol, 2024, 42(1): 19-27.

Funding

The National Natural Science Foundation of China(82271020)

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