Our case reports

Closure of diastema with direct composite restorations

Dr. Marco Veneziani

” The patient displays wide diastemas in the upper anterior sector, further accentuated by the loss of periodontal support due to previous periodontal disease, that was treated and stabilized. The diastemas can be seen even when the lips are at rest but become especially evident in the dynamic phases of smiling. The patient now has a good plaque control, she is motivated and wishes to improve her dental aesthetics. A very conservative treatment with direct composite adhesive restorations is proposed to her. ”

To see the complete case report and follow all the steps, please look at the attachment or the details below.


Fig. 1:

Wide diastemas in the upper anterior region, very evident in the dynamic phases of smiling

Fig. 2:

Power bleaching at the chairside

Fig. 3:

Restoration masses (Estelite Sigma Quick) are chosen by directly applying the composite (without adhesive) on the teeth

Fig. 4:

The anterior teeth group with wide diastemas, especially between the central incisors and between the lateral incisor and the left cuspid

Fig. 5:

Surfaces are cleansed using pumice paste and chlorhexidine

Fig. 6:

Air-flow with glycine powder

Fig. 7:

Surfaces are "reactivated" by means of abrasive discs and fine diamond burs

Fig. 8:

Etching of enamel-dentinal surfaces with 37% orthophosphoric acid

Fig. 9:

Laboratory rigid silicone matrix stent

Fig. 10:

Layering of composite masses for the palatal aspect using a matrix stent for guidance

Fig. 11:

Layering of interproximal masses using preformed sectional matrices of transparent acetate and wood wedges

Fig. 12:

Final result after finishing, polishing and glossing surfaces. The closure of the diastemas between central incisors, between central and lateral incisors and between lateral incisors and cuspids is evident. Furthermore, the incisal margin of tooth 11, which was partially fractured, has been restored

Fig. 13:

The front teeth two weeks after being restored

Fig. 14:

This detail of the central incisors shows the excellent integration and naturalness of the restorations



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