**4.1. Treatment of diastemas in the mixed dentition**

In the majority of cases, the central interincisive diastemas in the mixed dentition period are a temporary physiological feature of the "ugly duckling phase" [12, 13], which will be closed gradually with the eruption of the permanent lateral incisors and then with the eruption of the permanent canines. However, orthodontic interception is indicated in exceptional cases, where the diastema is preventing normal eruption of permanent teeth, stimulating the appearance or maintenance of deleterious habits, or compromising the child's self-esteem [16].

#### **4.2. Treatment of diastemas in permanent dentition**

There are several approaches used in the treatment of anterosuperior diastema, which vary according to the present etiologic factor [2, 16, 17]. The success of such treatment will depend on the elimination of these factors [17].

#### *4.2.1. Orthodontic treatment*

The orthodontic approach can be performed with the following objective: close the diastema or redistribute the spaces for a posterior reanatomization of the anterior teeth. Orthodontic treatment also has the function of treating, if present, any other associated occlusal problem and helping in the elimination of parafunctional habits. In cases where there is discrepancy of dental size, orthodontic treatment alone is not able to offer the best results. Therefore, these diastemas must be closed by means of composites, facets, or prosthetic crowns. However, for a better esthetic result of these restorations, orthodontic movement is indicated to redistribute the spaces before the cosmetic procedure [31].

Proffit, in the new volume of his book [32], divides the protocol of treatment of anteroposterior diastema according to two basic groups: (1) incisors with diastema and vestibular inclination and (2) diastema in the upper midline. In the first group, the diastema is usually caused by deleterious habit, which must be removed before the space closes, which can only 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 pressed in the midline.

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 anterior retraction [24].
