Review Article
Volume 19 Issue 7 - 2020
Correction and Closing of the Midline Diastema in Children
Karimi M*
Department of Pediatrics Dentistry, Sepideh Dental Clinic, Iran
*Corresponding Author: Karimi M, Department of Pediatrics Dentistry, Sepideh Dental Clinic, Iran.
Received:January 31, 2020; Published: June 19, 2020


A mismatch in tooth and jaw size in children can lead to midline diastema. Its incidence varies greatly in age groups. Multiple factors may contribute to the formation of midline diastema which including wrong oral habits, dental or skeletal anomalies, physical barriers, and soft tissue disharmony. In additions, some other factors such as genetic, normal dento-alveolar can play roles. Closure of diastema and spaces can be accomplished by orthodontic movement or by restorations. Any orthodontic movement is unlikely to be stable over long periods of time and some degree of retention, using either a removable appliance for night-time wear or a fixed wire retainer is inevitable.

Keywords: Diastema; Oral Habit; Orthodontic Movement; Dental or Skeletal Anomalies; Physical Barriers; Dento-Alveolar; Soft Tissue Disharmony


  1. GO Omotoso and E Kadir. “Midline Diastema amongst South-Western Nigerians”. The Internet Journal of Dental Science 8 (2010): 2.
  2. Huang WJ and Creath CJ. “The midline diastema: A review of its etiology and treatment”. Pediatric Dentistry Journal 3 (1995): 171-179.
  3. Wise RJ and Nevins M. “Anterior tooth site analysis (Bolten Index): How to determine anterior diastema closure”. The International Journal of Periodontics and Restorative Dentistry 6 (1988): 9-23.
  4. Azzaldeen A and Muhamad AH. “Diastema Closure with Direct Composite: Architectural Gingival Contouring”. Journal of Advanced Medical and Dental Sciences Research 1 (2015): 134-139.
  5. Abu-Hussein M., et al. “An Interdisciplinary Approach for Improved Esthetic Results in the Anterior Maxilla Diastema”. Journal of Dental and Medical Sciences12 (2015): 96-101.
  6. Foster TD and Grundy MC. “Occlusal changes from primary to permanent dentitions”. Journal of Orthodontics 13 (1986): 187-193.
  7. Becker A. “The median diastema”. Dental Clinics of North America 22 (1978): 685-710.
  8. Bishara SE. “Management of diastemas in orthodontics”. American Journal of Orthodontics 61 (1972): 55-63.
  9. Nainar SM and Gnanasundaram N. “Incidence and etiology of midline diastema in a population in south India (Madras)”. The Angle Orthodontist 59 (1989): 277-282.
  10. Oesterle LJ and Shellhart WC. “Maxillary midline diastemas: a look at the causes”. Journal of the American Dental Association 130 (1999): 85-94.
  11. Gardiner JH. “Midline spaces”. The Dental Practitioner and Dental Record 17 (1967): 287-297.
  12. Schmitt E., et al. “An autosomal dominant syndrome of radial hypoplasia, triphalangeal thumbs, hypospadias, and maxillary diastema”. American Journal of Medical Genetics 13 (1982): 63-69.
  13. Proffit WR and Fields HW. “Contemporary Orthodontics”. 2nd St. Louis: Mosby Yearbook (1993): 467.
  14. Attia Y. “Midline Diastema: closure and stability”. The Angle Orthodontist 63 (1993): 209-212.
  15. Moyers R. “Handbook of Orthodontics, 4th edition”. Year Book Medical Publishers (1988): 348-360.
  16. Muhamad Abu-Hussein and Watted Nezar. “Maxillary Midline Diastema – Aetiology and Orthodontic Treatment- Clinical Review”. IOSR Journal of Dental and Medical Sciences (2016).
  17. Kavadia S., et al. “Agenesis of maxillary lateral incisors A global overview of the clinical problem”. Orthodontics 12 (2011): 296-317.
  18. Fekonja A. “Hypodontia in orthodontically treated children”. European Journal of Orthodontics 27 (2005): 457-460.
  19. Gkantidis N., et al. “Management of maxillary midline diastema with emphasis on etiology”. The Journal of Clinical Pediatric Dentistry 32 (2008): 265-272.
  20. Darshan HE and Pavithra PM. “Tongue tie: from confusion to clarity-a review”. International Journal of Dental Clinics 3 (2011): 48-51.
  21. Ceremello PJ. “The superior labial frenum and the midline diastema and their relation to growth and development of the oral structures”. American Journal of Orthodontics 39 (1953): 120-139.
  22. Angle EH. “Treatment of malocclusion of the teeth, 7th Edition”. Philadelphia: SS White Co (1907): 103-104.
  23. Bergstrom K., et al. “The effect of superior labial frenectomy in cases with midline diastema”. American Journal of Orthodontics 63 (1973): 633-638.
  24. Dewel BF. “The labial frenum, midline, diastema, and palatine papilla: a clinical analysis”. Dental Clinics of North America 10 (1966): 175-184.
  25. Richardson ER., et al. “Biracial study of the maxillary midline diastema”. The Angle Orthodontist 43 (1973): 438-443.
  26. Popovich F., et al. “The maxillary interincisal diastema and its relationship to the superior labial frenum and inter-maxillary suture”. The Angle Orthodontist 47 (1977a): 265-271.
  27. Broadbent BH. “Ontogenic development of occlusion”. The Angle Orthodontist 11 (1941): 223-241.
  28. Munshi A and Munshi AK. “Midline space closure in the mixed dentition: A case report”. Journal of Indian Society of Pedodontics and Preventive Dentistry 2 (2001): 57-60.
  29. Koora K., et al. “Spontaneous closure of midline diastema following a frenectomy”. Journal of Indian Society of Pedodontics and Preventive Dentistry 25 (2007): 23-26.
  30. Kokich VO Jr and Kinzer GA. “Managing congenitally missing lateral incisors, Part I: Canine substitution”. Journal of Esthetic and Restorative 17 (2005): 5-10.
  31. Kinzer GA and Kokich VO Jr. “Managing congenitally missing lateral incisors, Part II: tooth-supported restorations”. Journal of Esthetic and Restorative Dentistry 17 (2005): 76-84.
  32. Kinzer GA and Kokich VO Jr. “Managing congenitally missing lateral incisors. Part III: single-tooth implants”. Journal of Esthetic and Restorative Dentistry 17 (2005): 202-210.
  33. Spilka CJ and Mathews PH. “Surgical closure of diastema of central incisors”. American Journal of Orthodontics 76 (1979): 443-447.
  34. Naini FB and Gill DS. “Oral surgery: Labial frenectomy: Indications and practical implications”. British Dental Journal 225 (2018): 199-200.
  35. Nagalakshmi S., et al. “Changes in quality of life during orthodontic correction of midline diastema”. Journal of Pharmacy and bio-Allied Sciences1 (2014): S162-S164.
  36. McNamara JA., et al. “Invisible retainers”. Journal of Clinical Orthodontics 19 (1985): 570-578.
  37. Sheridan JJ., et al. “Essix retainers: Fabrication and supervision for permanent retention”. Journal of Clinical Orthodontics 27 (1993): 37-45.
  38. Lindauer SJ And Shoff RC. “Comparison of Essix and Hawley retainers”. Journal of Clinical Orthodontics 32 (1998): 95-97.
  39. AL do Valle., et al. “A multidisciplinary approach for the management of hypodontia: Case report”. Journal of Applied Oral Science5 (2011): 544-548.
  40. Turpin DL. “Treatment of missing lateral incisors”. American Journal of Orthodontics and Dentofacial Orthopedics 125 (2004): 129.
  41. J Jofré and A Werner. “Use of mini implants to replace a missing tooth in a growing patient: a six-year follow-up case report”. European Journal of Pediatric Dentistry (2015).
  42. Guideline of American Association of Orthodontist (2014).
  43. Marie Leavy., et al. “Malocclusion and its relationship to speech sound production: Redefining the effect of malocclusal traits on sound production”. American Journal of Orthodontics and Dentofacial Orthopedics 150 (2016): 116-123.
  44. Larsson E. “The effect of finger sucking on the occlusion: A review”. European Journal of Orthodontics 9 (1987): 279-282.
  45. Ovsenik M., et al. “Follow-up study of functional and morphological malocclusion trait chances from 3 to 12 years of age”. European Journal of Orthodontics 29 (2007): 523-529.
  46. Warren JJ and Bishara SE. “Duration of nutritive and nonnutritive sucking behaviors and their effects on the dental arches in the primary dentition”. American Journal of Orthodontics and Dentofacial Orthopedics 121 (2002): 347-356.
  47. Russel KA and Folwarczna MA. “Mesiodens - diagnosis and management of a common supernumerary tooth”. Journal of the Canadian Dental Association 69 (2003): 362-366.
  48. Gündüz K., et al. “Mesiodens: a radiographic study in children”. The Journal of Oral Science 50 (2008): 287-291.
  49. Roychoudhury A., et al. “Mesiodens: a retrospective study of fifty teeth”. Journal of Indian Society of Pedodontics and Preventive Dentistry 18 (2000): 144-146.
  50. Sumit Yadav., et al. “Palatally impacted maxillary canine with congenitally missing lateral incisors and midline diastema”. American Journal of Orthodontics and Dentofacial Orthopedics 144 (2013): 141-146.
Citation: Karimi M. “Correction and Closing of the Midline Diastema in Children”. EC Dental Science 19.7 (2020): 71-77.

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