Journal of Prosthetic Dentistry
Clinical Report| Volume 119, ISSUE 4, P502-505, April 2018

Download started.


A multidisciplinary approach to the management of a maxillary midline diastema: A clinical report


      A maxillary midline diastema (MMD) is a common complaint of dental patients. An MMD can be closed with treatment from different disciplines, including operative dentistry and orthodontics. A comprehensive smile analysis is also a necessity before beginning treatment. This article highlights the closure of a 3-mm MMD by using a combination of orthodontics and direct composite resin restorations.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Prosthetic Dentistry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Bernabe E.
        • Flores-Mir C.
        Influence of anterior occlusal characteristics on self-perceived dental appearance in young adults.
        Angle Orthod. 2007; 77: 831-836
        • Chu C.H.
        • Zhang C.F.
        • Jin L.J.
        Treating a maxillary midline diastema in adult patients: a general dentist’s perspective.
        J Am Dent Assoc. 2011; 142: 1258-1264
        • Keene H.
        Distribution of diastemas in the dentition of man.
        Am J Phys Anthropol. 1963; 21: 437-441
        • Edwards J.G.
        The diastema, the frenum, the frenectomy: a clinical study.
        Am J Orthod. 1977; 71: 489-508
        • Proffit W.R.
        • Fields H.W.
        • Sarver D.M.
        Contemporary orthodontics.
        5th ed. Mosby/Elsevier, St. Louis2013: 451-452
        • Kuljic B.L.
        Merging orthodontics and restorative dentistry: an integral part of esthetic dentistry.
        J Esthet Restor Dent. 2008; 20: 155-163
        • Chu S.J.
        Range and mean distribution frequency of individual tooth width of the maxillary anterior dentition.
        Pract Proced Aesthet Dent. 2007; 19: 209-215
        • Bhuvaneswaran M.
        Principles of smile design.
        J Conserv Dent. 2010; 13: 225-232
        • De Araujo Jr., E.M.
        • Fortkamp S.
        • Baratieri L.N.
        Closure of diastema and gingival recontouring using direct adhesive restorations: a case report.
        J Esthet Restor Dent. 2009; 21: 229-240
        • Heymann H.O.
        • Hershey H.G.
        Use of composite resin for restorative and orthodontic correction of anterior interdental spacing.
        J Prosthet Dent. 1985; 53: 766-771
        • Heymann H.O.
        The artistry of conservative esthetic dentistry.
        J Am Dent Assoc. 1987; (Spec No:14E-23E)
        • Spear F.M.
        • Kokich V.G.
        A multidisciplinary approach to esthetic dentistry.
        Dent Clin North Am. 2007; 51 (x-xi): 487-505
        • Francisconi L.F.
        • Freitas M.C.
        • Oltramari-Navarro P.V.
        • Lopes L.G.
        • Francisconi P.A.
        • Mondelli R.F.
        Multidisciplinary approach to the establishment and maintenance of an esthetic smile: a 9-year follow-up case report.
        Quintessence Int. 2012; 43: 853-858
        • Tjan A.H.
        • Miller G.D.
        • The J.G.
        Some esthetic factors in a smile.
        J Prosthet Dent. 1984; 51: 24-28
        • Dietschi D.
        Optimising aesthetics and facilitating clinical application of free-hand bonding using the ‘natural layering concept’.
        Br Dent J. 2008; 204: 181-185
        • Mussig E.
        • Lux C.J.
        • Staehle H.J.
        • Stellzig-Eisenhauer A.
        • Komposch G.
        Applications for direct composite restorations in orthodontics.
        J Orofac Orthop. 2004; 65: 164-179
        • Blatz M.B.
        • Hurzeler M.B.
        • Strub J.R.
        Reconstruction of the lost interproximal papilla–presentation of surgical and nonsurgical approaches.
        Int J Periodontics Restorative Dent. 1999; 19: 395-406
        • Han T.J.
        • Takei H.H.
        Progress in gingival papilla reconstruction.
        Periodontol 2000. 1996; 11: 65-68
        • Wolff D.
        • Kraus T.
        • Schach C.
        • Pritsch M.
        • Mente J.
        • Staehle H.J.
        • et al.
        Recontouring teeth and closing diastemas with direct composite buildups: a clinical evaluation of survival and quality parameters.
        J Dent. 2010; 38: 1001-1009