Morphological variations of the labial frenum, type of attachment and presence of diastemas: integrative review / Variações morfológicas do freio labial, tipo de inserção e presença de diastemas: revisão integrativa

ABSTRACT Objective: The aim of the present literature review was to compile data on the frequency of morphological and attachment types of the upper and lower labial frenum in different populations and investigate the association between the attachment level of the upper labial frenum and the occurrence of diastemas. Methods: Searches were conducted between May and June 2021 in the Medline (via Ovid), Google Scholar and CAPES databases. Thirty-eight studies that evaluated frenum morphology, frenum morphology and attachment or frenum morphology, attachment and the occurrence of diastemas were selected for the extraction of data. Results: Based on the data compiled in this review, the most common morphological and attachment types were labial frenum normale and mucosal attachment. The papillary and papilla penetrating types of attachment were more associated with the occurrence of diastemas. Conclusion: Longitudinal studies are needed to investigate this correlation in children and adults.

RESUMO Objetivo: O objetivo dessa revisão de literatura é compilar dados referentes a frequência de tipos morfológicos e de inserção do freio labial superior ou inferior, em diferentes populações, além de avaliar a relação entre o nível de inserção do freio labial superior e a ocorrência de diastemas. Métodos: Foram consultadas as bases de dados Medline (via Ovid), o Google acadêmico e o portal periódicos CAPES. A pesquisa foi realizada no período compreendido entre os meses de maio e junho de 2021. Foram selecionados para a extração de dados 35 estudos, que avaliação a morfologia do freio ou morfologia e inserção ou morfologia, inserção e presença de diastemas. Resultados: A partir dos dados compilados por essa revisão, foi possível estabelecer que os tipos morfológicos e de inserção mais comuns foram freio labial simples e inserção em mucosa. Com relação ao tipo de inserção e a ocorrência de diastemas, os tipos papilar e papilar penetrante foram os mais associados à sua ocorrência. Conclusão: Há necessidade de estudos longitudinais que avaliem essa correlação em crianças e populações adultas.

Modified Frenectomy Technique to Eliminate the Aberrant LabialFrenum – A Report of Two Cases

Introduction: A modified frenal treatment for aberrant frenum is presented in this report to reduce scar tissue formation and maintain the attached gingiva. Description: The case report describes two cases in which a V-shaped incision removed the aberrant frenum and then the flaps of the frenum were sutured at the mid line. Results: The results showed reduced scar tissue in the mid line and the tissue healed with adequate attached gingiva. Take-Away Lessons: The modified frenotomy technique presented here is ideal for a large frenum that could expose the underlying connective tissue that could reduce the scar tissue formation.

Cierre de diastema con alineadores en dentición mixta / Diastema closure with aligners in mixed dentition

En la dentición mixta y permanente temprana, el diastema puede ser una preocupación estética importante para los pacientes y/o sus padres. Este artículo describe el tratamiento de ortodon cia con placas alineadoras, realizado en una pacien- te de 9 años de edad, con diastema interincisivo. Luego de 10 meses de tratamiento, se lograron los objetivos propuestos. El caso se acompaña con fotos, radiografías y renders iniciales y finales(AU)

In mixed and early permanent dentition, diastema can be a major aesthetic concern for patients and their parents. This article describes the orthodontic treatment with aligning plates, performed on a 9-year-old patient with an interincisal diastema. After ten months of treatment, the proposed objectives were achieved. The case is accompanied by photos, x-rays and initial and final renders.

Midline diastema closure using a lithium disilicate glass ceramic fragment: increased long-term color stability"

ABSTRACT: Nowadays, maxillary midline diastema (MMD) can be treated with different multidisciplinary approaches. When restorative dentistry is needed, glass-matrix ceramic materials is one of the best choices, since they present good optical behavior and high survival rates in the anterior dentition. To obtain an adequate interphase, and color integration are one of the main restorative goals, and for that purpose, specific finishing and polishing procedures must be employed to avoid staining and ensure the restoration's color stability. In the case report presented in this article, a single lithium disilicate ceramic fragment was performed to close a MMD produced by the shape alteration of one of the maxillary central incisors. Also, the finishing and polishing procedure is discussed.

Lentes de contacto dentales: una alternativa de tratamiento estético

RESUMEN El presente reporte tuvo como objetivo presentar la planificación y ejecución de un tratamiento rehabilitador con el empleo de la técnica de lentes de contacto dentales para la resolución estética de la forma y tamaño de las piezas dentales. Se reportó el caso de un paciente de sexo masculino de 20 años de edad que presentaba inconformidad con su sonrisa por la presencia de diastema en los incisivos centrales de la arcada superior; por lo que se efectuó un tratamiento estético con el empleo de lentes de contacto dentales de disilicato de litio, en el cual se realizó un desgaste mínimo de la superficie dental para garantizar una correcta inserción y adaptación de los laminados de cerámica. Al año del seguimiento no se detectaron infiltraciones, sensibilidades o fracturas en los dientes rehabilitados con esta técnica. Entre las ventajas de lentes de contacto dentales o lumineers, como también es conocida, presenta una máxima conservación de la estructura dental, además, de altos niveles de estética por su gran translucidez y brillo similar a la de los dientes naturales.

ABSTRACT The objective of this report was to present the planning and execution of a rehabilitative treatment with the use of the dental contact lens technique for the aesthetic resolution of the shape and size of the teeth. The case is a 20-year-old male patient who presented dissatisfaction with his smile due to the presence of diastema in the central incisors of the upper arch. An aesthetic treatment was carried out with the use of lithium disilicate dental contact lenses. Minimal wear of the dental surface was implemented, to guarantee a correct insertion and adaptation of the ceramic laminates. After one year of follow-up, no infiltrations, sensitivities or fractures were detected in the teeth rehabilitated with this technique. Among the advantages of dental contact lenses or lumineers, as it is also known, is that it presents a maximum preservation of the dental structure, as well as high levels of aesthetics due to its great translucency and brightness similar to that of natural teeth.

RESUMO O objetivo deste relatório foi apresentar o planejamento e execução de um tratamento reabilitador com a utilização da técnica de lentes de contato odontológicas para a resolução estética da forma e do tamanho dos dentes. Foi relatado o caso de um paciente do sexo masculino, 20 anos, que apresentava insatisfação com o sorriso devido à presença de diastemas em incisivos centrais da arcada superior; Para tanto, foi realizado um tratamento estético com a utilização de lentes de contato odontológicas de dissilicato de lítio, no qual foi realizado um desgaste mínimo da superfície dentária para garantir a correta inserção e adaptação dos laminados cerâmicos. Em um ano de acompanhamento, não foram detectadas infiltrações, sensibilidades ou fraturas nos dentes reabilitados com esta técnica. Dentre as vantagens das lentes de contato ou luminárias odontológicas, como também é conhecido, apresenta uma preservação máxima da estrutura dentária, bem como elevados níveis de estética devido a sua grande translucidez e brilho semelhante ao dos dentes naturais.

Superior labial frenectomy by double clamping techniche: clinical case report

The lip brake is a fold in the oral mucosa, originating in the upper lip and insertion in the alveolar mucosa. At birth, the labial frenum may be inserted in the palatal papilla. As the individual grows, he can migrate to a more upper region, featuring a normal lip curl. However, when it remains inserted in the papilla, it is a case of hypertrophic lip curl. When pathological, this structure can promote the formation of interincisal diastema, periodontal pocket, gingival retraction, aesthetic problems, difficulties in phonation and brushing. The objective of this article is to report a clinical case of upper lip frenectomy using the double clamping technique or Archer technique, performed at the Oral Minor Surgery clinic of the Dentistry School of the Federal Fluminense University, in a male patient, leucoderma, 23 years old, indicated by his orthodontist after recurrence of interincisal diastema. From the procedure performed, it can be concluded that the surgical intervention and the applied technique were effective in solving the reported clinical case.

Impacto da presença de diastema na autopercepção do sorriso em uma amostra de adolescentes / Impact of the presence of diastema on the self-perception of one's smile in a sample of adolescents

Objetivo: Verificar a prevalência de diastema em adolescentes, analisar fatores associados e investigar o impacto dessa má oclusão na autopercepção dos adolescentes em relação ao seu sorriso. Métodos:A amostra consistiu em 160 adolescentes. Tratou-se de um estudo transversal e quantitativo realizado em escolas privadas (A1) e públicas (A2), no período de agosto de 2020 à julho de 2021, na cidade de Parnaíba, Piauí. Inicialmente, aplicou-se um questionário epidemiológico. A seguir, o exame clínico foi realizado sob luz natural, em ambiente escolar. Os alunos que apresentaram diastema constituíram o grupo G1 e os que não apresentaram formaram o grupo G2. Nos alunos do G1 foram identificadas a localização e a medida do diastema e dos possíveis fatores associados e aplicado um segundo questionário sobre a auto avaliação estética do sorriso. Foram realizadas estatísticas descritivas, obtendo-se porcentagens, frequências e análises de associação com o teste qui-quadrado e comparações de média a partir do teste t. Resultados:Houve diferença significativa na distribuição de adolescentes quanto ao tipo de escola e presença de diastema, verificando-se maior prevalência na escola pública. Quanto ao gênero, não foi encontrada diferença estatisticamente significativa, assim como não houve associação entre o sorriso e a presença de diastema, pois a maioria não apresentava vergonha ao sorrir, estava satisfeita e julgava ter um sorriso agradável. Verificou-se, quanto aos fatores associados, uma distribuição significativa com maior prevalência de "discrepância de tamanho dentário". Conclusão: A presença de diastema teve como fator associado predominante, a discrepância de tamanho dentário. A maioria dos adolescentes afirmaram estar satisfeitos com o sorriso, apesar de não ser agradável, considerando desnecessário o tratamento.

Aim: To verify the prevalence of diastema in adolescents, analyze associated factors, and investigate the impact of this malocclusion on adolescents' self-perception of their smile. Methods:The sample consisted of 160 adolescents. This was a cross-sectional and quantitative study carried out in private (A1) and public (A2) schools, from August 2020 to July 2021, in the city of Parnaíba, Piauí, Brazil. Initially, an epidemiological questionnaire was applied. The clinical examination was then performed under natural light, in a school environment. Students who presented diastema formed the G1 group, and those who did not, formed the G2 group. In G1 students, the location and measurement of the diastema and possible associated factors were identified and a second questionnaire was applied on the self-assessment of the esthetic smile. Descriptive statistics were performed, obtaining percentages, frequencies, and association analysis using the chi-square test and mean comparisons using the t test. Results: There was a significant difference in the distribution of adolescents regarding the type of school and presence of diastema, with a higher prevalence in public schools. Regarding gender, no statistically significant difference was found. There was also no association between smiling and the presence of diastema, as most were not ashamed to smile, were satisfied, and thought they had a pleasant smile. Regarding the associated factors, there was a significant distribution with a higher prevalence of "tooth size discrepancy". Conclusion: The presence of diastema was predominantly associated with tooth size discrepancy. Most adolescents said they were satisfied with the smile, despite not being pleasant, considering the treatment unnecessary.

Manifestations cliniques et traitements des diastemes chez les personnes adultes à l'hopital national Donka / Clinical manifestations and treatments of diastemas among people adults at hospital national Donka

Le diastème du grec diastèmà (interstice) se définit comme étant l'existence d'espace entre les dents d'une même arcade. Les objectifs de l'étude étaient de déterminer le profil épidémiologique des diastèmes; décrire les formes cliniques rencontrées, assurer une prise en charge. PATIENTS ET MÉTHODE: Il s'agissait d'une étude prospective de type descriptif effectuée à l'hôpital national Donka, elle avait duré sept mois, allant du 1er Mars au 30 septembre 2019. RÉSULTATS: Le sexe féminin prédominait avec 77,7% contre 22,2 % de sexe masculin, donnant un ratio (f/h) = 3,5. La tranche d'âge de 21-23 ans (tout sexe confondu) était la plus représentée avec un pourcentage de 44,4%. La tonicité du frein labial médian avec 29,62% était l'étiologie principale du diastème inter incisif. Le diastème était plus fréquent au maxillaire avec des valeurs respectives de 33,33% de diastème des dents du bloc incisivo canin et 29,62% de diastème inter incisif soit au total 62,96 %. Le traitement fut chirurgical, orthodontique et prothétique. CONCLUSION:Le diastème reste l'une des anomalies orthodontiques fréquente dans nos pays. Considéré par certains comme un excès de place sur l'arcade dentaire, il est cependant apprécié par d'autres, surtout en Afrique de l'ouest où il est souvent considéré par la population comme signe de chance, de beauté, d'où son impact socio-culturel.

Longitudinal evaluation of diastema closure in patients submitted to labial frenectomy in different phases of the mixed dentition A historical cohort

Background: There is a controversy in the literature concerning the indications for frenectomy to treat interincisal diastema. Aims and Objectives: The aim of this study was to evaluate the spontaneous closure of the interincisal diastema in patients submitted to upper labial frenectomy (ULF) during the mixed dentition. Materials and Methods: Records from patients treated between 2009 and 2014 in the course of Pediatric Dentistry Surgery at Fundecto–USP were evaluated to select those that were submitted to ULF during the mixed dentition using the Chelotti technique. Initial clinic characteristics and radiographic data related to the abnormal upper labial frenum were collected. The patients were called for a return visit to evaluate the diastema closure. The prevalence of children with diastema reduction after the frenectomy was determined by descriptive analysis. Logistic regression was used to evaluate the association between exposure factors and diastema reduction. Results: From 449 eligible records, 53 were selected and 25 were in a return visit. It was not possible to find association between the exposure factors and diastema closure. Conclusion: There is no relation between the time of surgery intervention and diastema closure. However, the intervention during the mixed dentition led to a partial diastema reduction in 80% of the cases.

Rehabilitación estética y funcional de una paciente con caninos retenidos / Cosmetic and functional rehabilitation of a patient with retained canine teeth

Se describe el caso clínico de una paciente de 18 años de edad, quien acudió a la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba, por presentar persistencia de caninos temporales. Para el diagnóstico y tratamiento exitoso fue necesaria la participación de un equipo multidisciplinario integrado por especialistas en: ortodoncia, imagenología, prótesis y cirugía maxilofacial, quienes corroboraron la retención de caninos superiores. Mediante el tratamiento conjunto de ortodoncia y prótesis, se logró la rehabilitación estética y funcional de la paciente.

The case report of an 18 years patient is described. She went to Mártires del Moncada Teaching Provincial Stomatologic Clinic in Santiago de Cuba, due to persistence of temporary canine teeth. The participation of a multidisciplinary team integrated by specialists in: orthodontics, imaging, prosthesis and maxillofacial surgery was necessary for the successful diagnosis and treatment. They corroborated the retention of upper canine teeth. By means of the combined treatment of orthodontics and prosthesis, the patient cosmetic and functional rehabilitation was achieved.

Management of a patient with angle class I Malocclusion with Anterior Crossbite and Maxillary Central Diastema caused by high attachment of the Maxillary Labial Frenulum

@#Maxillary Central diastema is common and normal for the growth and development of the anterior segment. If the central diastema persists after the eruption of the permanent cuspids, the orthodontist should clarify the etiology and establish a treatment plan. This case report discusses a 22-year-old woman with anterior crossbite and central diastema due to a high maxillary labial frenulum attachment. Treatment was performed using a fixed orthodontic appliance with a posterior bite raiser. Frenectomy was performed at the end of the orthodontic treatment.

Esthetic harmonization of front upper teeth using composite resin: a clinical case report / Harmonização estética de dentes ântero-superiores com resina composta: relato de caso clínico

ABSTRACT Every day, professionals who work with esthetics are faced with the challenge of meeting patients expectations who longs for a perfect smile, where every detail must show harmony and naturality. In this context, composite resin reanatomization is widely indicated for small corrections of color and shape in one or more dental elements, for diastema closure and sometimes for correction of small dental misalignment. The case report presented here discuss the planning and treatment for the esthetic and functional improvement of the dental units 1.1, 1.2, 2.1 and 2.2, by making direct restorations in composite resin. The patient sought the Faculty of Dentistry of UFBA in search of esthetic treatment, reporting dissatisfaction with the smile. During an evaluation, the thickness and size of the upper back teeth were dissonant, besides of the interincisal diastema and a discrete gyroversion of the lateral incisors, which together compromised the esthetic area of the smile. Therefore, the proposed treatment for solving this clinical situation was direct esthetic rehabilitation with composite resin in units 1.2 to 2.2. After obtaining the study models, it was accomplished diagnostic waxing and silicone guide as auxiliary resources on the planning and restorative stage. Nanoparticulate composite resins were used, making a stratification technique to obtain a harmonic result. The treatment was able to reproduce the esthetic and natural appearance of the teeth, through a conservative alternative, fast and with an excellent cost-benefit relation when compared to the indirect techniques.

RESUMO Profissionais que trabalham com estética se deparam diariamente com o desafio de atender as expectativas dos pacientes que anseiam por um sorriso perfeito, onde cada detalhe deve evidenciar harmonia e naturalidade. Neste contexto, a reanatomização em resina composta é amplamente indicada, para pequenas correções de cor e forma, em um ou mais elementos dentais, para fechamento de diastemas e, por vezes, para correção de pequenos desalinhamentos dentais. O relato de caso aqui apresentado discute o planejamento e tratamento realizado para a melhora estética e funcional das unidades dentais 1.1, 1.2, 2.1 e 2.2, por meio da confecção de restaurações diretas em resina composta. A paciente procurou a Faculdade de Odontologia da UFBA em busca de tratamento estético, relatando insatisfação com o sorriso. Durante a avaliação, foi observada desarmonia de espessura e tamanho em dentes ântero-superiores, além de diastema interincisal e discreta giroversão dos incisivos laterais, que em conjunto comprometia a zona estética do sorriso. O tratamento proposto para solucionar esta situação clínica foi a reabilitação estética direta com resina composta nas unidades 1.2 ao 2.2. Após a obtenção dos modelos de estudo, foi realizado o enceramento diagnóstico e guia de silicona como recursos auxiliares no planejamento e etapa restauradora. Foram utilizadas resinas compostas nanoparticuladas, realizando a técnica de estratificação para a obtenção de um resultado harmônico. O tratamento realizado conseguiu reproduzir a aparência estética e natural dos dentes, através de uma alternativa conservadora, rápida e com ótima relação custo-benefício quando comparada às técnicas indiretas.

Síndrome de Ellis Van Creveld / Ellis Van Creveld syndrome

Resumen El síndrome de Ellis van Creveld es un trastorno autosómico recesivo, caracterizado por mutaciones en los genes ECV y ECV2, los cuales son importantes para el desarrollo osteocondral. A nivel mundial, se han reportado aproximadamente 300 casos ,presentándose con mayor frecuencia en poblaciones endogámicas. Se caracteriza por distrofias óseas, displasias ectodérmicas y malformaciones cardíacas. El diagnóstico clínico puede ser confirmado mediante pruebas moleculares. A continuación, se presenta el caso de una paciente diagnosticada con el síndrome, la cual fue evaluada de manera interdisciplinaria. Esta revisión permitió dar a conocer un nuevo caso de la patología, relacionar las manifestaciones clínicas de la paciente con la literatura y describir nuevos hallazgos que pueden correlacionarse con el síndrome.

Abstract Ellis Van Creveld syndrome is an autosomal recessive disorder, characterized by mutations of the genes ECV and ECV2, which are very important in the osteochondral development. Worldwide, there have been reported around 300 cases that are commonly evidenced in populations where endogamy is typical. It is clinically characterized by bone dystrophies, ectodermal dysplasias, and congenital heart defects; the diagnosis can be confirmed by molecular tests. In the lines below, a case of a patient that suffers from this syndrome, and that was examined in an interdisciplinary way will be presented. This review allows us to show a new case of this pathology, to relate the clinical symptoms of the patient with the existing literature, and to describe new findings that can be correlated with the Ellis Van Creveld condition.

Reanatomização dentária e sua importância nos resultados estéticos do sorriso: relato de caso / Dental rehabilitation and its importance the aesthetic results of smile: case report

Uma das tendências da odontologia é a área da estética que consiste na harmonização entre dentes, gengivas, lábios e face. O objetivo deste trabalho é relatar um caso clínico de reanatomização dentária pela técnica restauradora direta com resina composta, onde a queixa principal do paciente se baseava nos espaços interdentais e formato dos dentes na região anterior. Foi elaborado um plano de tratamento que consistiu inicialmente na realização da moldagem de estudo, enceramento diagnóstico e mock-up, onde foi detectada a necessidade de uma gengivoplastia. Em seguida foi realizado um tratamento clareador e então o procedimento restaurador pela técnica direta com resina composta. Sendo assim, obteve-se um resultado satisfatório, suprindo as expectativas do paciente, conservador, pois não houve necessidade de desgaste dentário e com grande previsibilidade técnica.

One of the trends of dentistry, is the area of aesthetics, consists of harmonization between teeth, gums, lips and face. The objective of this study is to report a clinical case of dental reanatomization using the direct composite resin restorative technique, where the patient's main complaint was based on interdental spaces and tooth format in the anterior region. For the solution of the case the following procedures were performed: study molding, diagnostic waxing, mock-up, through this procedure the need for a gingivoplasty was detected, followed by a bleaching treatment and then the restorative procedure by the direct resin technique composed. Thus, a satisfactory result was obtained, supplying the patient's expectations, conservative because there was no need for dental wear and with great technical predictability.

Reabilitação estética e funcional com facetas pré-fabricadas em resina composta: relato de caso / Aesthetic and functional rehabilitation with prefabricated resin facets: case report

Atualmente é constante a demanda por sorrisos harmoniosos nos procedimentos clínicos odontológicos, resultando em estímulos no desenvolvimento de técnicas minimamente invasivas, sistemas adesivos e materiais que sejam capazes de reproduzir as características naturais dos elementos dentários. Para as reabilitações estéticas, em especial nas unidades anteriores, os laminados cerâmicos apresentam destaque, em virtude das suas características físicas e ópticas. Como procedimento alternativo, as facetas pré-fabricadas em resina composta foram reintroduzidas na Odontologia Restauradora, exibindo versatilidade, facilidade e relação custo/benefício satisfatórias. Objetivo: Relatar um caso, demostrando uma das opções viáveis para solucionar problemas estéticos, como diastemas e desproporções dentárias. Relato de caso: A paciente procurou atendimento odontológico especializado relatando insatisfação com o sorriso. Durante avaliação, foram observados desarmonia nas proporções dentárias, diastemas múltiplos, restaurações deficientes em resina composta e fraturas nas bordas incisais. Diante disso, após o registro fotográfico, foi realizado a seleção do formato e cor das facetas pré-fabricadas, assim como, do agente de cimentação. A seguir, foi feito o isolamento relativo, remoção das restaurações deficientes e os ajustes das facetas ao dente. Para preparação da peça, foi realizado a limpeza e aplicação do adesivo; nos preparos dentários, após asperização da superfície, houve o condicionamento e aplicação do adesivo, a seguir procedeu-se a etapa de cimentação e, acabamento e polimento. Conclusão: O tratamento realizado conseguiu suprir as necessidades estéticas do sorriso da paciente, mostrando que as facetas préfabricadas em resina composta apresentam estética satisfatória, facilidade de instalação, baixo custo em relação as peças em cerâmica e conservação da estrutura dentária(AU)

Introduction: In present days, there is a constant demand for harmonious smiles in the dental clinical procedure, resulting in encouragement on development in minimally invasive techniques, adhesives systems and materials that can be capable to reproduce natural dental elements. For aesthetic rehabilitation in special in the anterior units, the ceramic laminates are highlighted due to their optical and physical features. As an alternative procedure, prefabricated composite resigns have been reintroduced into restorative dentistry, showing satisfactory versatility, ease and cost-effectiveness. Objective: Report a case, showing one of the viable options to solve aesthetical problems as diastemas and dental disproportions. Case Report: The patient sought specialized dental care reporting dissatisfaction with the smile. During evaluation, disharmony in tooth proportions, multiple diastemas, composite deficient resigns restorations and incisal edges fractures were observed. Therefore, after the photographic register, the shape and colour of the prefabricated facets, as well as cementing agent were selected. Hereinafter, relative isolation, removal of the deficient restorations and adjustments of tooth's veneers were then performed. For the piece preparation, cleaning and adhesive application were performed; on dental preparations, after the surface roughening, the adhesive was etched and applied followed by finishing and polishing cementation. Conclusion: The treatment was able to supply the aesthetical needs of the patient's smile, showing that prefabricated composite resigns veneers present satisfactory aesthetics, ease installation, low cost compared to ceramic pieces and conservation of the dental structure(AU)

Diastema: precisando terminologia anatomica / Diastema: specifying terminologia anatomica

RESUMEN: Diastema es un término latino de origen griego incorporado a Terminologia Anatomica bajo el código A05.1.03.078. Odontológicamente, es un espacio interdentario ubicado entre dientes adyacentes del arco dental, siendo su presencia considerada normal en el periodo de dentición mixta. Fueron consultados diccionarios de los idiomas español, griego y latín, de términos médicos y etimológicos, en búsqueda de las apariciones iniciales del término diastema y sus posteriores usos en la historia. La búsqueda reportó que Diastema ha sido utilizado para indicar una distancia o intervalo, referido a lugares, tiempos e incluso entre tonos musicales. En el área de las ciencias médicas, es un término que ha señalado la separación entre los dedos o el espacio virtual creado por la insuflación de los pulmones, siendo su mayor acercamiento a la morfología en el área veterinaria para designar el espacio que separa los dientes anteriores de posteriores, especialmente en roedores y rumiantes. Para ser consistentes con los lineamentos actuales de la Federative International Programme for Anatomical Terminology y los acuerdos terminológicos de los Simposios Ibero-Latinoamericanos de Terminologia Anatomica, Histologica y Embryologica, sugerimos el reemplazo del término Diastema por Spatium interdentale, como un avance en la precisión y descripción de la estructura incorporada a Terminologia Anatomica.

SUMMARY: Diastema is a latin term of greek origin incorporated into Terminologia Anatomica under the code A05.1.03.078. Odontologically, it is an interdental space located between teeth adjacent to the dental arch, its presence being normal in the period of mixed dentition. Dictionaries of the Spanish, Greek and Latin languages, of medical and etymological terms were consulted, in search of the initial occurrences of the term Diastema and its subsequent uses in history. The search reported that Diastema has been used to indicate a distance or interval, referring to places, times and even between musical tones. In the area of medical sciences, it is a term that has indicated the separation between the fingers or the virtual space created by insufflation of the lungs, being its closest approach to morphology in the veterinary area to designate the space that separates the incisors and molars tooth, especially in rodents and ruminants. To be consistent with the current guidelines of the International Federative Program of Anatomical Terminology and the terminological agreements of the Ibero-Latin American Symposia of Anatomical, Histological and Embryological Terminology, we suggest the replacement of the Diastema period with Spatium interdentale, as an advance in accuracy and description of the structure incorporated into Terminologia Anatomica.

Fechamento de diastema com resina composta: relato de caso / Closure of diastema with composite resin: case report

Este trabalho tem o objetivo relatar um caso clínico de fechamento de diastema inter incisivos pela técnica de restauração direta em com resina composta. Paciente, sexo feminino, compareceu a Clínica Integrada de Adultos queixando-se da estética do seu sorriso devido à coloração amarelada e um espaço presente entre os dentes incisivos superiores. No exame clínico notou-se a presença de diastema mesial entre os dentes 11 e 21. Foi feito um plano de tratamento, no qual foi sugerido a paciente o fechamento do diastema por meio de restaurações diretas com resina composta. Após a aprovação da paciente, foi selecionada a cor dos dentes com o auxílio da Escala Vita e proposto a realização de um clareamento antes do tratamento restaurador. Realizado o clareamento e após ter aguardado 21 dias para estabilização da cor, deu início a etapa restauradora, a qual consistiu no ataque ácido seguido pela aplicação do sistema adesivo. A resina composta foi sendo colocada em incrementos de 1mm com o auxílio de fita de poliéster a fim de restabelecer a parede palatina e o contato interproximal. Posteriormente, a resina foi sendo colocada até a face vestibular respeitando a anatomia dentária. Uma semana após a restauração, foi realizado acabamento e polimento com pontas diamantadas tronco-cônicas de granulação fina, discos de lixa, disco de feltro e pasta diamantada. O resultado satisfatório após o fechamento do diastema pela técnica direta em resina composta demonstrou-se uma opção de tratamento viável, uma vez que restabeleceu a função e a estética do sorriso da paciente.

This paper aims to report a clinical case of closure of inter-incisive diastema by the technique of direct restoration with composite resin. A female patient attended the Integrated Adult Clinic complaining about the aesthetics of her smile due to the yellow color and a space between the upper incisor teeth. In the clinical examination, the presence of mesial diastema between teeth 11 and 21 was noted. A treatment plan was made, in which the patient was suggested to close the diastema by means of direct restorations with composite resin. After the patient's approval, the color of the teeth was selected with the aid of the Vita Scale and it was proposed to perform a whitening procedure before the restorative treatment. After bleaching and after waiting 21 days for color stabilization, the restorative stage began, which consisted of the acid attack followed by the application of the adhesive system. The composite resin was placed in 1mm increments with the aid of polyester tape in order to reestablish the palatal wall and interproximal contact. Subsequently, the resin was placed up to the buccal surface, respecting the dental anatomy. One week after the restoration, finishing and polishing was carried out with fine-grained cone-shaped diamond tips, sanding discs, felt disc and diamond paste. The satisfactory result after the closure of the diastema by the direct technique in composite resin proved to be a viable treatment option, since it restored the function and aesthetics of the patient's smile.

Arch parameters and dental discrepancy (crowding and spacing) in a sample of an Afro-Colombian population / Parámetros de arco y discrepancia dental (apiñamiento y espaciamiento) en una muestra de población Afrocolombiana

The aim of this study was to determine the differences in arch length, inter-canine distance, inter-premolar distance, intermolar distance and arch shape between dental discrepancies (crowding and spacing) in a sample of dental casts from the Afro-Colombian population of San Basilio de Palenque. An analytical, cross-sectional study was conducted on a convenience sample of 63 subjects aged 11 to 57years, of Afro-Colombian origin, with full dentition from first molar to first molar, without extensive caries or restorations, and excluding casts with defects due to loss. The differences between arch (upper and lower) variables were analyzed according to dental discrepancies. Plaster models digitalized with a TR1OS3 Mono scanner with exactitude (6.9 ± 0.9 pm) and precision (4.5 ± 0.9 pm) were analyzed with Orthonalyzer software. Statistical analyses were done on SPSS software (Version 20 for Windows) and Real Statistics. Spacing discrepancy of68.25% was found for upper arch and 66.66% for lower arch; crowding discrepancy of 19.04% for upper arch and 20.63% for lower arch, and an adequate ratio of 12.69% for both arches. No statistically significant difference (p>0.05) was found between arch parameters except for inter-premolar distance on the lower arch. The most frequent arch shape in the population was oval for both upper arch, with 76.19%, and lower arch, with 71.42%. Tooth size was larger in males than females but the difference was not statistically significant.

El objetivo de este estudio fue determinar las diferencias en longitud de arco, distancia intercanina, interpremolar, intermolar y la forma de arco entre discrepancias dentales (apiñamiento y espaciamiento), en una muestra de modelos dentales de la población afrocolombiana de San Basilio de Palenque. Se realizó un estudio analítico transversal, en una muestra por conveniencia de 63 sujetos con un rango de edad entre 11 y 57 años, de origen afrocolombiano, quienes tuvieron dentición completa de primer molar a primer molar, sin caries extensas, ni restauraciones; se excluyeron los modelos con defectos por el vaciado. Se analizaron las diferencias entre las variables de los maxilares (superior e inferior) con las discrepancias dentales. Se utilizaron modelos de yeso que fueron digitalizados con el escánerTR1OS3 Mono con una exactitud de (6.9 ± 0.9 pm) y una precisión de (4.5 ± 0.9 pm)y analizados con el software Orthonalyzer. Los análisis estadísticos se llevaron a cabo utilizando el software SPSS (Versión 20 para Windows) y Real Statistics. Se encontró una discrepancia de espaciamiento de un 68,25% para el arco superior y 66,66% en el arco inferior; y una discrepancia de apiñamiento en el arco superior de 19,04% e inferior de 20,63% y una relación adecuada de 12,69% para los dos arcos. No se encontraron diferencias estadísticamente significativas (p>0.05) en los parámetros de arco a excepción de la distancia interpremolar del arco inferior. La forma de arco más frecuente en la población fue ovalada tanto en el arco superior con un 76,19% como en el arco inferior con un 71,42%. En cuanto al tamaño dental, se presentó mayor tamaño en los hombres que en las mujeres, pero este no fue estadísticamente significativo.

The use of direct composite resin to close maxillary midline diastema complementary to orthodontic treatment

ABSTRACT: The maxillary midline diastema is a common esthetic problem in patients. Assess and diagnose may be challenging due to the many factors that influences the alteration of tooth eruption process and tooth shape. Due to the various advantages and the reversibility of treatments, composite resins are today a suitable aesthetic and functional option, even so, its management and technique require a trained and experienced clinician in order to obtain an optimal outcome. The following report, is a clinical case of a 21-year old female with a main complaint of a maxillary midline diastema produced by the alteration in tooth shape and size of both upper central incisors, which was closed and corrected with direct composite resins.

Prevalence of Median Diastema in a Sample of Iraqi Population Concerning on the Mesiodistal Width of Anterior Teeth and Frenal Attachment as Etiological Factors

Aim: The purpose of this study was to evaluate the prevalence of mid line diastema between the group of Iraqi students of Dentistry College in Baghdad University, and to determine the etiological factors of this diastema whether it is due to height frenal attachment or due to the discrepancy in the width of the anterior teeth as etiological factors or/and another cause and to determine the gender difference. Materials and methods: Out of 600 students aged between 18-23 years were clinically examined; only 41 students (30 females and 11 males) fulfilled the inclusion criteria and were having diastema. Maxillary median diastema and mesiodistal width of the sex upper anterior teeth was measured directly (intra orally) with stainless steel vernier calipers. Results: Results showed that about 30 females and 11 males were only having maxillary midline diastema from the total sample. There was no significant difference between males and females concerning the width of maxillary middiastem. In both sexes, the mesiodistal width of all anterior teeth was nearly equal except the maxillary left lateral incisors which were significantly wider in females than in males. Conclusion: In dentally aware societies the presence of diastema was un-aesthetic so many students improved such appearance by orthodontic treatment or restorative veneer, therefore Iraqi students had less prevalence of maxillary diastema than other studies. Females express more prevalence of maxillary midline diastema than male. Mesiodistal width of upper anterior teeth is nearly within the normal range of Iraqi norms. Another etiological factor such as hereditary, genetic or oral habit can be considered as a cause of diastema in our sample who have diastema without high frenal attachment or tooth width discrepancy.