Causes of median diastema
- Developmental – Physiological central diastema may be quite natural till the time of eruption of permanent canines, particularly at the `Ugly Duckling` stage.
- Missing teeth, particularly lateral incisors.
- Mild generalized spacing of teeth
- Congenitally missing teeth
- Peg laterals
- Supernumerary teeth in the midline between the roots of the incisors.
- Extraction of teeth in well aligned or large arch.
- Midline cystic lesion
- Thumb sucking
- Tongue thrusting
- Abnormal labial frenum
- Retained deciduous teeth
- Palatally erupted lateral incisors.
- During rapid palatal expansion.
Treatment of median diastema
- Elimination of causes, if any.
I. Extraction of supernumerary teeth
II. Surgical removal of abnormal frenum, midline cystic lesion etc.
- Can be corrected by using removable orthodontic appliance:
II.Finger springs with labial bow
III. Split labial bow
- Can also be corrected by using sectional fixed orthodontic appliance:
I. Pin and tube appliance
II. Band the maxillary central incisors and attach brackets or buccal tube. Place a sectional arch wire and use elastic force in the form of figure eight or elastic modules.
III. In case of missing lateral incisor, gain space by using space regainer for the replacement of missing lateral or if there is inadequate space for the replacement of missing laterals, a canine can be brought forward and its shape suitably altered to look as a lateral.