Anterior Diastema Closure Using Frenectomy and Direct Composite Resin Restoration: A Case Report

Abstract

Midline diastema (MD) is defined as a space greater than 0.5 mm between the proximal surfaces of fully erupted maxillary or mandibular central incisors, with a higher prevalence in the maxillary arch. It is commonly observed during the mixed dentition phase and is considered a normal developmental finding, often closing spontaneously after the eruption of permanent maxillary canines. Persistence of MD into adulthood is usually associated with specific etiological factors such as tooth-size discrepancies, excessive incisal overlap, abnormal incisor angulation, generalized spacing, and aberrant labial frenum attachment. A high or hypertrophic labial frenum with fibers extending into the interdental papilla plays a significant role in the development and maintenance of MD by exerting continuous tensile forces that interfere with space closure and increase the risk of relapse. Therefore, elimination of this etiological factor through frenectomy is often recommended prior to restorative intervention. Management of MD may involve orthodontic, surgical, restorative, or multidisciplinary approaches based on the underlying cause. Diastemas primarily caused by tooth-size discrepancies are particularly suitable for restorative management. Direct composite resin restorations provide a conservative, cost-effective, and aesthetically predictable treatment option, especially with advances in materials and techniques. This case report highlights the importance of performing frenectomy before direct composite resin closure to achieve stable, functional, and aesthetically pleasing outcomes.