[Maxillary central diastema. A case study]

A case is presented with loss of two maxillary central incisors in a 12 year old girl due to the use of elastics around the teeth to close a median diastema. The patients complaint was an increased mobility of these teeth. She presented a Class I malocclusion and a supraposition of the upper central incisors. There was however an extreme periodontal destruction, as a consequence of which the central incisors had to be extracted. In connection with this case report considerations are made concerning the normal development of the dentition and the need for orthodontic treatment of a median diastema in the maxilla. A median diastema normally closes when the canines erupt. A hypertrophic superior labial frenum rather seems to be a consequence than a cause of a median diastema. Thus, it is no use to close a median diastema before eruption of the upper canines. If a median diastema is to be treated, use of elastics around the central incisors is contraindicated.