Single Shade Diastema Closure

A clinical case by our Community member Dr. Riccardo Galetti

This article and its content are published under the Author’s responsibility as an expression of the Author’s own ideas and practice. Styleitaliano denies any responsibility about the visual and written content of this work.

This young patient was asking for the closure of his diastema in the frontal area. This was a residual orthodontic treatment related diastema between teeth 11 and 21.

style italiano styleitaliano teeth isolated with rubber dam

Fig.1
After providing proper isolation of the sextant, the soft tissues were retracted with the rubber dam, and the teeth surfaces were cleaned.

style italiano styleitaliano sandblasting enamel under rubber dam isolation

Fig.2
Teeth were also sandblasted as a first surface treatment.

style italiano styleitaliano etching of proximal enamel

Fig.3
Then the bonding area of the enamel was etched with 37% orthophosphoric acid.

style italiano styleitaliano brusoni bonding agent

Fig.4
Bonding was applied to the surface as there was no dentin exposed, air dried and then polymerized for 40 seconds.

style italiano styleitaliano proximal wall composite build up

Fig.5
One single shade (A2 body) was applied with the help of a sectional matrix inserted in the dam in order to stabilize it. No wedge was placed in order to build the emergence profile as apically as possible.

style italiano styleitaliano partial diastema closure with direct composite

Fig.6
Detail of the restoration of tooth 11.

style italiano styleitaliano marked line angles

Fig.7
After finishing the restoration on tooth 21, the hypothetical transitional lines were traced with a pencil, and then followed with the discs and burs to define the proper primary anatomy.

style italiano styleitaliano finished and polished build up

Fig.8
Final result after finishing and polishing, before removing the rubber dam.

style italiano styleitaliano check up after closing diastema with direct composite restoration

Fig.9
At 2-week check-up the papilla had grown back to its original position, and color integration was optimal.

Conclusions

The use of a single body shade strategy is, in our everyday practice, a useful solution for closing diastemas with just a few steps. With non-invasive treatments and just the addition of some material, we can radically change the outcome of many orthodontic treatments that end with some little imperfections.

Bibliography

1. Goyal A, Nikhil V, Singh R. Diastema Closure in Anterior Teeth Using a Posterior Matrix. Case Rep Dent. 2016;2016:2538526. doi: 10.1155/2016/2538526. Epub 2016 Oct 13. PMID: 27818804; PMCID: PMC5081967.
2. Prabhu R, Bhaskaran S, Geetha Prabhu KR, Eswaran MA, Phanikrishna G, Deepthi B. Clinical evaluation of direct composite restoration done for midline diastema closure – long-term study. J Pharm Bioallied Sci. 2015 Aug;7(Suppl 2):S559-62. doi: 10.4103/0975-7406.163539. PMID: 26538917; PMCID: PMC4606659.
3. Brianezzi LFF, Brondino BM, Chaves GC, Ishikiriama SK, Furuse AY. Interdental papilla formation after diastema closure. Gen Dent. 2017 Nov-Dec;65(6):e13-e16. PMID: 29099376

style italiano styleitaliano Essential Dentistry kit online on demand course
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