Valente Marta Santos Oliveira, Neto Constantino Fernandes, Obeid Alyssa Teixeira, Furuse Adilson Yoshio, Ishikiriama Bella Luna Colombini, Ishikiriama Sergio Kiyoshi, Velo Marilia Mattar Amoêdo Campos
Gen Dent. 2023 Sep-Oct;71(5):53-57.
Determining the appropriate technique for diastema closure is challenging, and the decision must be evidence based. The objective of these case reports is to describe different approaches to diastema closure using direct and indirect techniques, focusing on the characteristics of the patient and clinical requirements to guide treatment. In the first case, a 16-year-old patient had multiple diastemas in the maxillary anterior dentition. The clinical evaluation revealed microdontia of the lateral incisors and malpositioned teeth. The treatment included tooth whitening and placement of composite resin veneers using a direct technique. In the second case, a 54-year-old patient displayed a disharmonious and esthetically compromised smile due to small teeth, color changes, multiple diastemas, incisal wear, and severe dentogingival disproportion. Based on the patient's expectations, the patient's age, and the presence of a "black triangle" interdental space, a multidisciplinary restorative treatment was proposed, including gingivoplasty, tooth whitening, and placement of ceramic laminate veneers using an indirect technique. Both approaches achieved successful esthetic rehabilitation and diastema closure with minimal intervention. The choice of procedure and restorative material, as well as the need for tooth preparation, varied based on the clinical requirements, patient expectations, and financial constraints. Careful treatment planning avoided lengthy and inefficient procedures.
确定关闭牙间隙的合适技术具有挑战性，且该决定必须基于证据。这些病例报告的目的是描述使用直接和间接技术关闭牙间隙的不同方法，重点关注患者的特征和临床需求以指导治疗。在第一个病例中，一名16岁患者上颌前牙区有多个牙间隙。临床评估显示侧切牙过小和牙齿错位。治疗包括牙齿美白和使用直接技术放置复合树脂贴面。在第二个病例中，一名54岁患者因牙齿过小、颜色改变、多个牙间隙、切缘磨损和严重的牙齦比例失调，笑容不协调且美观受损。基于患者的期望、年龄以及存在“黑三角”牙间隙，提出了多学科修复治疗方案，包括牙龈成形术、牙齿美白和使用间接技术放置陶瓷贴面。两种方法均以最小的干预实现了成功的美学修复和牙间隙关闭。手术和修复材料的选择以及牙齿预备的需求，根据临床需求、患者期望和经济限制而有所不同。精心的治疗计划避免了冗长且低效的程序。
