Diastema Closure with Bioclear

A diastema is a gap located between the upper front teeth. Diastemas are typically closed using orthodontic solutions or through restoration. One particularly successful and affordable technique used is the application of composite. When the space is too large and composite is used to reduce the space, it can result in teeth that are esthetically too wide. In this case, orthodontics is recommended. Space closure requires the placement of composite material on the two adjacent teeth. Placement of composite onto just one tooth is possible in the event the patient has the proper tooth dimensions. Anesthetic is not required for composite unless dentin or the tooth’s root structure is impacted. Diamond burs are used to prepare tooth’s structure as they create a rough surface which improve the strength of the bond. In addition, the burs produce bevels which show through tooth color at restoration cavosurface areas. A cross section of enamel rods are used to improve the enamel bond strength.

The back of the mouth is appears darker because it does not receive any light. Composite must block out darkness or the restoration will appear dark. The placement of opaque material to the lingual is covered with translucent material to the facial which helps achieve a more natural looking restoration which is not impacted by this darkness. Blending the composite color with the tooth color also helps achieve the proper composite selection, placement and preparation design. The placement of lingual opaque composite is not necessary when restoring a small diastemas.

Restoration to the enamel provides additional strength to hold composite onto tooth structure and helps minimize microleakage. The removal of caries often creates areas of mechanical locking that aids retention. Beveling across enamel rods is used to help increase the strength of enamel restoration. A longer bevel or chamfer preparation creates additional surface area for strength. It also provides a long gradual transparency of tooth color which allows an improved color transition. A translucent outer layer of composite results in a chameleon effect which picks up and shows through the surrounding color.

Gingival control helps to eliminate the black triangles from appearing in the papillae area. Placement of composite subgingival is achieved by the placement of a matrix which reflects gum tissue and allows the placement of the restoration.

The tooth structure is prepared, a plastic matrix is placed and etching and restoration is completed on one tooth. A lingual wall of composite is then placed which works to achieve ideal interproximal contours and light cured. Dimensions are either made exact or intentionally too large. It is difficult to add cured composite when the oxygen inhibited layer is lost, however, it is easy to remove.

Most dentists avoid wrapping a matrix because it produces a straight contour and also eliminates the oxygen inhibited layer. A contoured matrix or hand shaping produces convex interproximal areas. A layer of translucent composite is then placed across the facial area. The layer is shaped with special hand instruments and cured with a light.

The last part of the process involves shaping and polishing using burs, disks and rubber wheels in addition to polishing pastes. Mesial distal dimension is then measured on the restored tooth and compared to the dimension of the adjacent tooth and space to ensure proper alignment. Adjustments are then made to the restored tooth using burs or sandpaper disks.

More on BioClear : Fix Tooth Gap