Direct Resin Composite Restoration for Maxillary Midline Diastema Closure in a Patient with Low Frenum Attachment: A Case Report

Abstract

     This clinical case report aims to present a comprehensive diagnostic approach, management of underlying etiologic factors, direct resin composite restoration for maxillary midline diastema closure, and posterior prosthodontic rehabilitation to achieve long-term clinical success. This case study presented a Thai female patient who sought dental treatment due to broken and defective existing restorations on her maxillary central incisors. The dentist gathered data through history taking, oral examination, and radiographic evaluation. Diagnostic findings revealed defective restoration margins on the maxillary central incisors, a low-attached labial frenum crossing the alveolar ridge—identified as the primary etiologic factor for the diastema—and missing mandibular posterior teeth. A structured treatment plan was executed, comprising a labial frenectomy, removal of defective restorations, direct resin composite closure of the maxillary midline diastema, fabrication of a removable partial denture for the mandibular arch, and oral hygiene instruction. Treatment outcomes were evaluated based on clinical parameters, periapical radiographs, masticatory efficiency, and patient satisfaction at an 8-month follow-up.

     The results demonstrated that the resin composite restorations remained in good condition with excellent marginal adaptation to the teeth. The surrounding periodontal tissues were healthy with no radiographic evidence of additional alveolar bone resorption. The patient achieved efficient mastication and expressed high satisfaction with her smile aesthetics and dental contour.