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Direct Restorative Closure of Maxillary Midline Diastema Using a 3D-Printed Matrix: A Case Report
Yu Toida1, Shuhei Hoshika1, Kenta Tsuchiya1
1Department of Restorative Dentistry, Division of Oral Health Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan, hokudai.ac.jp.
Abstract:
Anterior midline diastema is a common esthetic concern that can adversely affect smile appearance. Direct composite resin restoration has emerged as a conservative treatment option for diastemas associated with tooth size discrepancies, as it allows intraoperative adjustment of tooth morphology and shade. Digital dentistry has improved clinical outcomes by increasing workflow efficiency, enabling integration with other healthcare technologies, and supporting more accurate and predictable treatments. The objective of this case report was to describe the management of anterior midline diastema and spacing in the maxillary anterior region using a 3D-printed matrix to achieve the intended esthetic outcome. An optical impression was acquired using an intraoral scanner. Because the occlusal relationship of the remaining dentition was stable, the maxillomandibular relationship was recorded using the same device. A maxillary incisal matrix was digitally designed using dental CAD software and fabricated with a 3D printer in a transparent photopolymerizable resin. After the matrix was positioned on the maxillary arch, a flowable composite resin was injected into the mold and subsequently light-cured. Occlusal interferences were eliminated, and all restorations were finished and polished using polishing strips and a silicone point. Postoperative instructions were provided. The teeth were successfully reshaped in accordance with the digital design, achieving the planned esthetic and functional improvements. Direct composite restoration using a 3D-printed matrix provides a rapid, convenient, and predictable approach for managing anterior midline diastema. This technique enables precise transfer of the digital design to the clinical setting, allowing improved control of morphology and symmetry. A 3D-printed matrix can therefore be considered a reliable alternative to conventional freehand composite restoration for maxillary anterior esthetic rehabilitation, particularly in cases involving midline diastema and spacing.

