Median Diastema Research Articles

The etiology and incidence diastema median maxillary

The aim of the study was to determine the etiology and incidence diastema median of the upper jaw, with tutins and rozajs high school. Biostatistical data collection, analysis and interpretation was conducted after specialist systematic review of 100 patients, of equal gender representation. Methodological defined parallel, divergent and convergent diastema median, measured in gingival and incisal part of the crown, using a digital vernier.In multicausal aetiology dominates heritage (37,05 %), ahead of the low attachment fibrous frenulum (14,28 %) and the discrepancies in the length of the dental arch and the size of the teeth (14,28 %). Diastema median is represented in 14 persons (14.0 %), of which at 5 females 5 (10,0 %) and 9 men (18,0 %). According to the most common form is represented parallel to the median diastema, in both sexes, more common in males (10.0 %) than females (6,0 %). The incidence of diastema median in the sample is higher than the representation of the majority of Europeans, but less than most African and Asian nations.

Pattern of malocclusion in patients seeking orthodontic treatment at Dhaka Dental College and Hospital

Aims: To evaluate the pattern and distribution of malocclusion in patients seeking orthodontic treatment in Dhaka Dental College Hospital.Material and Methods: Total of 400 patients were included in the study with a mean age of 19.10 years. A standard format was prepared to record the data. Ages, sex and Class I, II and III malocclusions were tabulated to cheek for any relationship.Results: The prevalence of molar class I, II, III and both (I &II) malocclusion were 61.53%, 22.56%, 8.2%, and 7.17%, respectively. The prevalence of incisors class I, class II division 1,classII division 2 and class III malocclusions were 36.92%, 39.74%, 2.56% and 14.87%. out of 400 cases the distribution of various occlusal abnormality were spacing 40%, crowding 46.92%, cross bite 23.07%, open bite 8.46%, impaction 6.41%, rotation 20%, median diastema 13.58%, absent teeth 7.69%, mesiodense 2.51% and cleft lip and palate was 1.28%. Most prevalence age group seeking orthodontics treatment was 16 to 20 years with female to male ratio 2.45 :1.Conclusion: class I malocclusion was the most prevalent followed by class II malocclusion and class III malocclusion showed least prevalence.Ban J Orthod & Dentofac Orthop, April 2013; Vol-3, No.2

Orthodontic Treatment Combination with Auto Transplantation for the Management of Impacted Maxillary Left Lateral Incisor and Canine: An Interdisciplinary Approach

Aims: For the orthodontic treatment of the complex cases, the interdisciplinary team work is of utmost importance, which leads to the predictable outcome with excellent treatment. The prime aim of this rare case report is to demonstrate the combined orthodontic-surgical-endodonticprosthodontic interdisciplinary management. Case Study Alam et al.; BJMMR, 4(3): 276-284, 2015; Article no.BJMMR.2015.449 277 Presentation of Case: This report describes the case of a 19 years old Malay male patient with the clinical problems of median diastema, mesio-buccally rotated maxillary left 1 st premolar, mild mandibular incisor crowding along with impacted maxillary left lateral incisor and canine. Discussion: With the advantages of the orthodontic fixed appliance, auto-transplantation of maxillary upper left lateral incisor and canine, the case was completed in an ideal orthodontic occlusion along with improved oral condition, masticatory function and esthetics. The treatment outcomes were due to orthodontic-surgical-endodontic-prosthodontic treatment with stable occlusion in sequels visits. Conclusion: An Interdisciplinary management achieved successful functional and esthetic results in the present case.

Bilateral double mesiodentes in the ugly duckling stage

The ugly duckling stage is a physiological stage characterized by a small median diastema and distally inclined incisors. A mesiodens is a supernumerary tooth found in the premaxilla between the two central incisors. It can be single or multiple, impacted, erupted, or inverted. We present a case of a 9-year-old nonsyndromic, asymptomatic male patient with bilateral double mesiodentes in the ugly duckling stage of the mixed dentition.

Orthodontic-restorative treatment of maxillary midline diastema

Introduction: Maxillary midline diastema in adults is an esthetic problem that alters the appearance of smile. This paper describes treatment of a large diastema in a middle-aged patient. Case Report: The case was a 52-year-old woman with a large median diastema and congenitally missing maxillary lateral incisors. A combined orthodontic and prosthetic approach was used to close the diastema and open up space for substitution of missing laterals by implants. Discussion: Despite the slow rate of tooth movement in adults, a large diastema was closed. This interdisciplinary approach improved the esthetic aspect greatly. The patient was satisfied even after four-years of follow-up period.

Diagnosis and Referral of Orthodontic Cases: An Institutional Survey among Dental Graduates

ABSTRACT General dentists play an important role in intercepting the progression of malocclusion. The right stage of referral to specialist orthodontist is considered key to the success of orthodontic treatment. The objective of this study was to assess the preparedness of fresh dental graduates in dealing with orthodontic patients in general dental practice. A total of 80 general dentists who had recently completed the BDS program formed the study group. They were asked to respond to a self-administered questionnaire consisting of case scenarios to evaluate their knowledge of Angles classification, occlusal characteristics, the ideal stage of treatment and need for referral to specialist orthodontist. The response rate was 75% (n = 60). 87% (n = 52) correctly identified the Angles Classification of the presented cases. 87% (n = 52) and 100% (n = 60) correctly identified overbite and over-jet cases. Cross bite and deviated midline was correctly identified by 68% (n = 41) and 65% (n = 39) of the respondents respectively while 93% (n = 56) diagnosed median diastema correctly. Almost all the respondents (97%) identified the cases which have to be referred to the orthodontist while, more than half (55%) did not know the ideal time to initiate orthodontic treatment. The graduates recognized their limits of personal competence and successfully identified the cases that need to be referred to the orthodontist. Proper emphasis should be placed on the ‘the ideal time of referral and initiation of treatment’ during undergraduate orthodontic training. How to cite this article AlShahrani I. Diagnosis and Referral of Orthodontic Cases: An Institutional Survey among Dental Graduates. World J Dent 2014;5(1):33-36.

The Prevalence of Peg Shaped and Missing Permanent Maxillary Lateral Incisors in Najaf City

Background: The presence of a missing or peg shaped lateral incisor is a major concern for the subjects facial esthetics. Objectives: The objectives are to find the prevalence of peg shaped and missing permanent maxillary lateral incisors in Najaf City. Methodology: A cross sectional study was constructed and composed of 416 Iraqi students (215 males and 201 females) randomly chosen of 3 colleges of Kufa University in Najaf. Each subject was examined by visual inspection under day light looking for missing or peg shaped permanent maxillary lateral incisors. Results: The prevalence of missing maxillary lateral incisors was 3.8% (16 subjects) with an insignificant gender difference. There were two unilateral missing maxillary lateral incisor and 14 bilateral cases. Prevalence of peg shaped laterals was 4.3% (17 subjects) with an insignificant gender difference. Maxillary median diastema was found in 15.4% of the sample. Presence of missing lateral incisors showed a significant relationship with the presence of a maxillary median diastema. Conclusions: The presence of missing or peg shaped lateral incisors was found to be statistically significantly related to the presence of spacing and the presence of peg shaped lateral incisor showed a non-significant relationship with the presence of a maxillary median diastema.

Unusual hyperpigmented patches, an undeveloped breast and a cataract in a female with incontinentia pigmenti

AbstractA 19‐year‐old female and her mother visited our department with a history of unusual reticular brown‐black patches on their trunks and limbs since infancy. Besides the obviously fulsome hyperpigmentation, the daughter also showed other unusual clinical manifestations such as generalized hypohidrosis, especially on the hyperpigmented patches, cicatricial alopecia, a cataract on her right eye, abnormal teeth and a right dysplastic breast. The mother had a median diastema between her maxillary central incisors, hypoplasia of the enamel, hypohidrosis and hyperpigmented patches on her left thoracic region. Analysis of the NEMO (NF‐κB essential modulator) gene in the patient and her mother revealed a deletion of exons 4–10. Their EDA and EDAR genes were normal.

Dynamic evaluation of anterior dental alignment in a sample of 8- to 11-year-old children

To describe perceptions related to different anterior dental alignments in a sample of 106 children aged between 8- and 11-years-old. We employed dynamic media (videos) showing a smile in four different arrangements (ideal incisal occlusion - N, median diastema - D, incisal crowding - A, protruding incisors - P), with and without general contextual attractiveness. The perception is the same both for the whole face and for the frontal smile alone and there are no significant differences between the answers from male and female interviews. Smiles with normal alignment gain higher scores for esthetics and are associated with more positive qualities. In contrast, smiles with proclined and crowded teeth obtain lower scores. Analysis of the results showed that there are no significant differences between perceptions, sensations and judgments related to smiles presented either as part of the whole face or in only the lower facial third: general facial attractiveness does not influence evaluations of the smile. The study confirms the general tendency to award higher scores to smiles with normal alignment.

Advantages and limits of 3-segment (paramedian) versus 2-segment (median) surgically assisted rapid maxillary expansion (SARME)

A novel maxillary 3-segment osteotomy (3SO) was evaluated versus the conventional 2-segment-osteotomy (2SO) for surgically assisted rapid maxillary expansion. 3SO was performed bilaterally between the lateral incisors and canines at the former junction of the lateral alveolar processes with the premaxilla. Of 98 included patients (n = 53 retrospectively and n = 45 prospectively; 68 complete datasets), 47 patients' preoperative and postexpansion cast models were evaluated for transverse maxillary dental and skeletal expansion, dental tipping, attachment loss, and front teeth angulation, and on photographs the pink esthetic score (PES) was assessed preoperatively versus postoperatively. Three-SO expanded to a larger extent with more symmetry than 2SO, at the price of more dental tipping and front teeth angulation (independent t test). The PES showed better esthetic outcomes for 3SO (Mann-Whitney U test). Disadvantages of 2SO, such as median diastema, midline shift, median papilla infringement, asymmetric expansion, septum and columella dislocation, high forces on the periodontal apparatus, and subsequent attachment loss were overcome with 3SO. Bilateral double osteotomies appeared to promote higher volumes of callus formation, thus preventing relapses.

Relapse of a maxillary median diastema: Closure and permanent retention

The purpose of this article was to describe the closure of a maxillary median diastema of a 26-year-old woman that had been corrected before during orthodontic treatment but reopened after dental trauma in a car accident. A clear esthetic device made from a tray like those used for home bleaching was used, providing a comfortable, nearly undetectable, and efficient solution. A permanent fixed retainer was bonded again to the maxillary central incisors to prevent relapse.

Malocclusion and occlusal traits among orthodontic patients seen at the University of Benin Teaching Hospital, Nigeria

Objective: The aim of this study was to determine the prevalence and trend of malocclusion and occlusal traits among orthodontic patients in Benin City.Method: One hundred and thirty one patients, consisting of 71 females (54.2%) and 60 males (45.8%) aged 5 - 44 years (mean 17.9 ± 7.5 years) who presented for orthodontic treatment at the University of Benin Teaching Hospital Dental Centre were assessed for sagittal molar occlusion, overjet, overbite, crossbite, open bite, crowding, spacing, median diastema, midline shift, malformed and supernumerary teeth, displaced, unerupted and impacted teeth. Statistical gender differences in the occlusal traits were evaluated with the chi-square test. Result: The results revealed high prevalence of Angle's class I malocclusion (71.8%), while 9.9% of the subjects had Angle's Class II division 1, 7.6% had Angle's Class II division 2 and 10.7% had Angle's class III malocclusion. An increased overjet greater than 3.5mm was observed in 43% while increased overbite was observed in 25.2%. Anterior open bite was seen in 8.4% while 21.4% and 12.2% had anterior and posterior crossbites respectively. Midline shift was present in 29.8%, crowding of both upper and lower anterior segments was observed in 47.3%, spacing in the upper and lower anterior segments was present in 22.1%, and midline diastema was observed in 21.4%. No statistically significant gender differences were observed for any of the occlusal variables evaluated (P>0.05).Conclusion: This study revealed high prevalence of class I malocclusion, increased overjet and crowding among the orthodontic patients seen in Benin City, Nigeria.Key words: Malocclusion, occlusal traits, orthodontic patients, Benin City, Nigerian

PROGNOSIS V/S ETIOLOGY: MIDLINE PAPILLA RECONSTRUCTION AFTER CLOSURE OF MEDIAN DIASTEMA

Reconstruction of lost interdental papilla once the contact point is restored in midline diastema cases are as well important in restoring the esthetics as closure of diastema. Aim: The purpose of this study was to predict the midline papilla reconstruction in treated median diastema of variable etiology. Method : The treated sample consisted of 40 patients with variable etiology of midline diastema (6 of abnormal labial frenum, 6 of mesiodens ,8 of anodontia or microdontia, 8 of para functional habits, 6 of flared or rotated incisors and 6 of dentoalveolar disproportion) with otherwise healthy periodontium. The method used was PPI (papilla presence index) by D.Cardaropoli. Results: The study suggests that prognosis for papillary reconstruction is not good in cases of mesiodens. Conclusion: In spite of getting a good contact point, various other factors are playing a role in achieving good esthetics in cases of median diastema.

Calcified Object in the Mid-Maxilla

A 60-year-old woman underwent multislice whole-body computed tomography for staging of a high-risk melanoma of the anus. The examination revealed no metastases but did reveal a round, calcified structure in the mid-maxilla (Panel A, arrow). In the sagittal reconstruction, a peg-shaped supernumerary tooth was identified (Panel B, arrow), which resulted in the diagnosis of an unerupted, inverted mesiodens. A mesiodens is a developmental disturbance that occurs during odontogenesis; the overall prevalence is 0.2 to 1.9%. A mesiodens can cause median diastema (an open space between the incisors), a dentigerous cyst (a cyst associated with the crown of an unerupted or . . .

The pattern of malocclusion in a sample of orthodontic patients from Turkey

The objective of this study was to determine the prevalence of individual traits of malocclusion in a sample of Turkish orthodontic patients. The present study was based on the examination of dental casts, intraoral photographs and panoramic radiographs of 1507 orthodontic patients (884 females and 623 males). The relationship of the first upper and lower molars according to the Angle's classification, overjet, overbite, crowding, spacing, posterior crossbite, scissor bite, maxillary median diastema were examined. The Pearson chi-squared and Fisher's Exact tests were used to determine potential differences in the distribution of malocclusion when stratified by gender. The study demonstrated that only 52 (3.5%) of the subjects had normal occlusion. Class I malocclusion was found in 626 (41.5%), Class II Division 1 in 435 (28.9%), Class II Division 2 in 142 (9.4%) and Class III malocclusion in 252 (16.7%) subjects of all examined. Normal overbite, normal overjet, crossbite on both sides and severe crowding in the upper dental arch were observed more frequently in females (P<0.05), however, increased overbite and moderate crowding in the upper dental arch were observed more frequently in males (P<0.05). The results of this study showed that crowding in the upper and lower dental arches in a sample of Turkish population was the most frequent of all anomalies recorded with ranges of 70.0% and 47.3%, respectively.

Clinical management of supernumerary teeth: A report of two cases

Supernumerary tooth may closely resemble the teeth of the group to which it belongs, i.e. molars, premolars or anterior teeth, or it may bear little resemblance in size or shape to which it is associated. Many complications can be associated with supernumeraries, like impaction, delayed eruption or ectopic eruption of adjacent teeth, crowding, development of median diastema and eruption into floor of the nasal cavity. This may also cause the formation of follicular cysts with significant bone destruction. Early intervention to remove it is usually required to obtain reasonable alignment and occlusal relationship. This article will present the clinical management of an (i) impacted supernumerary tooth impeding the eruption of maxillary central incisor and (ii) erupted supernumerary tooth with midline diastema.

New Species of Rock-Dwelling Hemidactylus (Squamata: Gekkonidae) from Gujarat, India

A new species of Hemidactylus gecko (Squamata: Gekkonidae) is described from Girnar in the Junagadh district of Gujarat, India. This medium-sized, chiefly rupicolous gecko may be distinguished from its south Asian congeners by having 12–16 rows of irregularly arranged, flattened to weakly conical dorsal tubercles, 7–9 subdigital lamellae on digit I of the pes and 10–11 on digit IV, and 12–14 femoral pores on each thigh separated by a median diastema. This is the second Hemidactylus currently regarded as endemic to Gujarat and the 10th member of the genus recorded for the state.

Aesthetic impact of malocclusion in the daily living of Brazilian adolescents

The aim of the present study was to determine the biopsychosocial impact of malocclusion on the daily living of Brazilian adolescents (14 to 18 years of age) through normative and subjective records and identify factors directly involved in the self-perception of malocclusions. Cross-sectional. Public and private schools in the city of Belo Horizonte, Brazil. The sample was made up of 403 adolescents, with no prior history of orthodontic treatment, who were selected randomly from a population of 182,291 students in the same age range. The oral impact of malocclusion was assessed using the Oral Impact on Daily Performance (OIDP), whereas clinical criteria were assessed using the Dental Aesthetic Index (DAI). Self-perception of dental aesthetics was assessed using the Oral Aesthetic Subjective Impact Scale (OASIS) and self-esteem was assessed using the Global Negative Self-Evaluation (GSE) scale. Other variables were assessed using questionnaires. The chi-square test, simple and multiple logistic regression analyses were used for the statistical analysis. Ninety five adolescents (24%) reported feeling embarrassed to smile (aesthetic impact). A logistic regression suggested that the following variables were directly involved in the self-perception of malocclusion: upper anterior crowding > or = 2 mm (P=0.009), median diastema > or = 2 mm (P=0.040), normative treatment need (highly desirable) (P<0.001) and low economic level (P<0.001). Negative repercussions on daily living were found in Brazilian adolescents with malocclusions affecting anterior dental aesthetics.

The effect of low level laser therapy (LLLT) on bone remodelling after median diastema closure: A one year and half follow-up study

Background and objectives Maintenance of a corrected median diastema after orthodontic treatment often requires permanent retention. This study was performed to evaluate low level laser therapy (LLLT) effect on bone density after diastema closure and to determine whether increased density will prevent diastema relapse. Study design Fourteen patients (22 ± 4.78 years) with median diastema (6.79 ± 2.28 mm) were randomly allocated to a lased and a non-lased group ( i = 7). The patients in the lased group were exposed to GaAs (904 nm, 30 mW, 5.4 J/session, 3 times/3 min each/every second day). Standardized periapical radiographs of the maxillary central incisors were taken immediately after diastema closure, and at 15 days, 45 days, 3 months, 6 months and 1.5 years. Bone density and linear distances were measured using Digora software. Results Diastema reopening showed no statistically significant differences between the two groups. Reduction in linear distances was noticed in the lased group. Mean percentage changes in bone density were statistically significant between the groups at 15 days and 6 months. Only the periapical area distal to the right central incisor retained significantly higher bone density after 1.5 years. There was an insignificant negative correlation between the diastema size and bone density in the lased group at all experimental periods. Conclusions LLL induced bone remodelling and prevented reduction in bone density in the lased group. Diastema reopening, although minor, did not seem to be significantly affected by the bone density changes. Further studies on a larger sample are necessary to optimize treatment parameters so LLL can be applied on a routine therapeutic basis.

Smile aesthetics and malocclusion in advertising models on Nigerian billboards

Objective: There is a growing influence of advertising media on the perception of dental appearance in the Nigerian society. This study examined the portrayal of malocclusion on advertising billboards that is directed at the Nigerian public Method: A representative selection of 100 advertising models on billboards from three major Nigerian cities was investigated. The prevalence and severity of malocclusions observed including the median diastema, which is of cultural importance, were assessed using a modification of Aesthetic Component of Index of Orthodontic Treatment Need (IOTN). Intra-examiner calibration of all the smiles showed adequate agreement. Result: It showed that the aesthetic scores were low for the majority of models (94%) indicating “no need or a borderline need” for treatment, whilst insignificant models (6%) exhibited a “definite need for treatment”. However, median diastema, a sign of personal beauty in this cultural setting did not feature prominently in the smile aesthetics. Conclusion: The study concluded that the portrayal of occlusal disharmonies on models in billboards may not be generalized to the entire Nigerian population. Keywords : Smile Aesthetics, Malocclusion, Advertising models, IOTN, Nigeria Nigerian Dental Journal Vol. 16 (1) 2008: pp. 19-21