Prepless Direct Midline Diastema Closure in a Single Visit: 18 months Follow-up Report

Abstract

Maxillary midline (major) diastemas are common aesthetic problems for the patients. Recently, it is easier to get rid of those unwilling spaces aesthetically with the help of newly developed restorative materials. Major diastema may frequently occur due to high frenulum junctions thus causing unaesthetic outlook for some patients. In this case report a maxillary major diastema due to high frenulum was closed non-invasively with direct, prepless composite resin restorations. In this case frenectomy, office bleaching and direct prepless restorations was respectively planned. Six weeks were waited for periodontal tissue healing after frenectomy operation and then bleaching procedure was done using 40% hydrogen peroxide gel ( Opalescence Xtra  Boost, Ultradent, USA ). Following vital bleaching; after 2 weeks, universal adhesive agent (Universal bond, Kuraray Noritake, Japan)  was applied to the etched enamel surfaces  (36% phosphoric acid etching  with DeTrey Conditioner 36, Dentsply, Germany).  Direct composite resin restorations was done using “A1B” and “NE” shades ( Estelite Asteria, Tokuyama Dental, Japan ).  Polishing discs  (SofLex, 3M ESPE, USA), interdental strips (Epitex, GC, Japan) and two spiral polishing twists (Twist Dia, Kuraray, Japan) was used during the finishing and polishing stages.  The success of the final restorations were assessed in 3 month, 9 month and 18 month follow ups.