Stability of Diastemas Closure after Orthodontic Treatment

Abstract

The prevalence of diastemas varies greatly according to age and ethnic group. In permanent dentition, it varies from 1.7 to 38%. Its etiology is multifactorial. In the deciduous and mixed dentition phases, interincisal diastemas are considered normal. There are several approaches used in the treatment of anterosuperior diastemas, which vary according to the present etiologic factor. Orthodontic treatment also has the function of treating any other associated occlusal problem and helping in the elimination of parafunctional habits. Some authors agree that orthodontic closure of diastemas without subsequent surgery for removing the abnormal labial brake greatly increases the frequency of relapse in the postretention period, while others concluded that the fibrotomy of periodontal fibers together with the retainer had a positive effect on the stability of space closure. Buccal and lingual teeth inclinations have greater tendency to relapse, while mesial and distal movements, with a period of containment, are stable movements. Removable retainers are not considered a good choice. Depending on the type of initial malocclusion, the use of retainers throughout life is recommended. Fixed retention is often cited as the only satisfactory method to promote stability at the closure of previous diastemas.

Morphological variations of the labial frenum, type of attachment and presence of diastemas: integrative review

“…Children have diastemas with larger interincisal spaces that tend to diminish with age and an inverse correlation is found between the level of gingival attachment and diastema [18,8,45,49,50]. Therefore, the frenum can affect the presence and magnitude of diastema in childhood in the presence of other conditions, such as a broad maxilla, small teeth, hypodontia and dental caries, but is not necessarily the most important determinant factor [18].…”

“…Therefore, the frenum can affect the presence and magnitude of diastema in childhood in the presence of other conditions, such as a broad maxilla, small teeth, hypodontia and dental caries, but is not necessarily the most important determinant factor [18]. In many individuals, the closure of diastemas occurs between 14 and 19 years of age [49].…”

The role of the maxillary labial frenectomy in closure of the midline diastema: A review and management recommendations

“…16 Diastema closure is not considered in the primary dentition and is only considered in the mixed dentition in select cases, such as when a large diastema is preventing the eruption of further permanent teeth. 27 The treatment options for diastema closure in the permanent dentition are often combined and are displayed in Table 3. Each option comes with its challenges, and an important consideration particularly in children, is their ability to cooperate with the required treatment.…”

“…43,44 We do know that an essential measure in preventing relapse following closure of a diastema, regardless of the presence of an enlarged frenum, is long term orthodontic retention. 27,45 There is no firm evidence to support maxillary frenectomies as a way of reducing the risk of relapse, and we should not necessarily routinely prescribe this procedure.…”