How to close a Diastema - Dr. Charles Bell

by Dr. Charles Bell 26. March 2012 08:56

Dr. Charles Bell

A Diastema is a space between the upper front two teeth. There are numerous reasons why this may have developed and there are also different possibilities on how to resolve this issue. This is primarily considered a cosmetic issue as there are no health reasons associated with this gap.

Orthodontics:

This is the ideal way of closing the anterior gap. There are obviously some limitations to this technique including your current bite, arch form, and the size of the space. The advantage to this option is that nothing has to be done to the actual structure of the front teeth.

Bonding:

If orthodontics is not an option, then bonding is a fairly simple way to close the gap. The teeth are simple made wider by bonding filling material to the middle edges of the teeth to make them wider and therefore close the space. This technique is easier for smaller gaps. As the size of the gap increases the strength of the final result is weakened and the chances for bond failure increases. This will have to be replaced periodically as the material slowly yellows, the material chips, and the edges of the bonding stain. From a cost perspective only this is a much easier choice. This technique is done especially in children or teenagers.

Laminates:

This is the technique that is used more commonly on adults or for larger diastemas. The porcelain that covers the entire tooth is custom made by a dental laboratory and then bonded over the teeth. Usually tooth structure is removed prior to the impression for the lab. This is considered more permanent than the bonding option, but even this requires maintenance and replacement every 10 years or so. This is not only a much more aesthetic procedure, but also much more expensive than the simple bonding technique. In both of the non-orthodontic options, care must be given to the overall aesthetic result. Simply eliminating the space is not the only consideration. The front teeth must look proportionate within the context of the entire smile. In many cases fixing this problem involves more than just the two teeth adjacent to the space to maintain a proportional smile.

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