**4. Treatment of anterosuperior diastemas**

In the deciduous and mixed dentition phases, interincisive diastemas are considered normal [11–13, 16]. However, in the permanent dentures, diastema is frequently associated with several occlusal problems, which include missing teeth, dental anomalies, abnormal bone structures, and excessive horizontal and/or vertical trespass [24]. It should be remembered that the diastema of racial and genetic etiologies are considered normal and the treatment will be dispensable, unless the patient considers the diastema an esthetic problem [24].

be performed with a removable device, retracting the incisors. In the second group, the author recommends the closure of the space, followed by frenectomy, in case there is excess tissue

Stability of Diastemas Closure after Orthodontic Treatment

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In cases where there is a deep overbite, it is interesting that it is corrected previously. This usually increases the horizontal overpass, making it possible to close spaces together with an

Labial frenulum is considered abnormal when it is enlarged and/or inserted near the gingival margin [15]. Some authors [16, 33] recommend frenectomy to be performed after orthodontic closure of space, since diastema closure and interdental papilla compression may act as a

Peck and Peck [34] stated that teeth are, by nature, perfect structures. However, a tooth with altered anatomy can often form a malocclusion. For the authors, the orthodontist should increase their understanding of the limitations of orthodontic therapy, and know the value of procedures to change dental forms. Only in this way can treatment success be achieved.

Andrews [35] cited in his book "Straight Wire: Concept and Apparatus" that when there are spaces between teeth due to discrepancy of tooth size, where there are small teeth, orthodontic correction is contraindicated, and recommend the restoration of these teeth with composites

However, even if there is a discrepancy of dental size, orthodontic treatment may be an auxiliary tool to redistribute the spaces between the teeth before the restorative procedure. This allows the dentition in the anterior teeth to be performed according to the golden ratio,

Bell [36] argued for the immediate closure of diastema by subapical and interdental osteotomy, justifying that there is a great unpredictability of diastole orthodontic closure stability and that this approach is difficult and takes a long time. In addition, the author believes that the alveolar bone is the major factor responsible for the difficulty in the orthodontic movement of the teeth and for the final stability, as opposed to the majority of authors who consider the

Concern over the stability of results obtained with treatment has existed for more than a

labial frenulum and adjacent soft tissues as the main factor for relapse.

stimulus to promote atrophy of the fibrous tissue interposed between the incisors.

pressed in the midline.

anterior retraction [24].

*4.2.3. Restorative treatment*

or prosthetic crowns.

obtaining a better esthetic result [24, 31].

**5. Stability of diastema treatment**

*4.2.4. Other types of treatments*

century [37].

*4.2.2. Frenectomies*

Patients' perception of the need for treatment for anterosuperior diastemas is influenced by the epoch and culture in which they live [29]. There is also a great contribution of the media to the opinion of people. In the 1960s, Gardiner [20] referred to a famous movie actor who presented a medium diastema and suggested, between the lines, that this feature, when smooth, may be well accepted for those individuals with a rather pleasant facial appearance. However, this cannot be considered for the majority of the population. The author's opinion was retracted through the following statement:

It was demonstrated [30] that when patients self-evaluate, they perceive a greater need for orthodontic treatment, when the problem is located in the anterior region, compromising aesthetics, as is the case of the anterosuperior diastema and anteroinferior crowding.
