Diastema closure with direct composite: architectural gingival contouring

Anterior diastema may compromise the harmony of a patient’s smile. Among the suggested options for diastema closure such as orthodontics, restorative dentistry, and prosthodontics, it is appreciable that restorative approach is the simplest, fastest, most predictable, and lowest solution. But, handling composite freehand requires skillful practice and it may be considered as a disadvantage to some operators. Also, one of the difficulties encountered is closing diastema without creating “black triangles”. It is especially difficult with wide gingival embrasure and thick gingival biotype. To prevent the formation of a black triangle between the teeth when closing diastema, it requires careful considerations in the gingival architecture based on the concepts of cervical contouring and location of the contact point. A number of studies were conducted to investigate the factors that influence the presence of the interdental papilla. It has long been known that the distance from the contact point (CP) to the alveolar bone crest (BC) is a significant determinant in whether a papilla will fill the interdental space. Tarnow et al. reported that interdental papilla were often present when the CP-BC distance was 5 mm. In order to determine the appropriate location of the contact point, a non-invasive method to measure the distance between the bone crest and the gingival crest was accomplished. Also, the traditional technique using Mylar strip was modified to increase the emergence profile with natural contours at the gingiDiastema closure with direct composite: architectural gingival contouring