Etiological factors of midline diastema-a retrospective study

Abstract

Aesthetics has become one of the major concerns worldwide, in children, adolescents and adults. Malocclusion is a morphological variation that may or may not be associated with pathological conditions. Anomalies in the tooth position, number, form and developmental position of the teeth beyond normal limits will all contribute to malocclusion. A “diastema” is the space between adjacent teeth. Maxillary midline diastema is a common esthetic problem in both mixed and permanent dentition. It can occur as either a transient malocclusion or due to developmental, pathological and iatrogenic causes. Some other causes include genetic, physiological, supernumerary teeth, abnormal frenum attachment, habits, tooth material, pathology, iatrogenic, etc. The aim of this study was to assess the common etiological factors that are associated with midline diastema. With this knowledge, it would be easier for dentists to diagnose cases with better understanding of the cause and also formulating an ideal treatment plan. They can eliminate the malocclusion at earlier stages. A retrospective study was done in an institutional setting to study the various etiological factors in the occurrence of a midline diastema. Among patients who visited the dental facility, the records of patients within the time period of June 2019 to March 2020 were chosen for this study. The patients detailed case sheets were analyzed using parameters such as age, gender and etiology. The data was sorted and was tabulated in excel. Analysis of the data was done in SPSS software. The association between age with etiology and gender with etiology were evaluated. A total of 236 patients were considered for this study. 69.9% being males and 30.1% being female patients with midline diastema. Midline diastema was seen to be more prevalent in the age groups of 20-40 years. It was least prevalent in 61-75 years age groups. The most common etiological factor that seemed to cause a midline diastema in the population was due to a high frenum attachment (39.83%). 23.31% of the patients had this as a generalized spacing due to habits, 12.29% of the patients had the presence of mesiodens. 10.17% of the patients were partially edentulous, 1.69% of the patients had peg laterals. Rotation of 11 and 21 was seen in 12.71% of the patients. Majority of the patients within the age group of 20-40 years had high frenum attachment. Patients within the age group of 61-75 years had a midline diastema due to their partial edentulism. The most common etiology for midline diastema was the presence of a high frenum attachment. The presences of various etiological factors have been overlooked. Regular dental visits can prevent such negligence and aid in improving esthetics..