Multidisciplinary clinical decision-making of anterior diastema closure

Anterior diastema is a common esthetic defect in China. The general treatment for a patient with diastemata, including orthodontics and direct and indirect restorations, is a multidisciplinary clinical procedure covering the orthodontics, operative dentistry, general dentistry, and prosthodontics department. Given the diversity of departments and the complex etiology of this defect, decision-making regarding the closing methods and time selection is undefined and unintegrated, which makes the long-term stability of closure unpredictable. This article proposed an etiology-based decision tree with actual measurement of diastemata width for diastemata closure. The decisional steps include classifying the etiological factors based on patients' medical history and clinical manifestation to evaluate the stability of diastemata. After maintaining the stability of diastemata, contemporary and multidisciplinary treatment plans were selected in accordance with the measured width of diastemata and patients' cosmetic psychology, economics, and available time. These decision trees focus on the challenges of collaboration among dental departments, propose an objective and efficient ways for connections, and promote efficient and effective diastemata closure.