CDEN0110

I 07 MICD _ diastema closure I cosmeticdentistry 1_2010 Clinicians must be prepared for patients visiting the dental office with the aim of having their di- astema closed in order to fulfil their psychological (aesthetic and beauty enhancement), functional (pronunciation of ‘f’ and ‘s’ sounds and cutting foods with anterior teeth) and/or health (oral- health maintenance) problems. _Treatment options for diastema closure Treatment modalities depend on the etiological factors and complexity of the MD. It is suggested that treatment of a MD should be delayed until the eruption of the permanent canines. However, the pathological causes should be ruled out and treated at an early stage, for example extraction of supernumerary teeth (mesiodens) and surgical treatment for the removal of midline cyst, tumour and periodontal pathologies. Surgical, orthodontic (comprehensive/short term), periodontal, direct- bondingandindirectrestorationsarethetreatment modalitiesthatcanbeusedaloneorincombination to achieve harmony in terms of a patient’s aesthet- ics, function and health. MICD by definition is “a holistic approach that explores the smile defects and aesthetic desires of apatientatanearlystageandtreatsthemusingthe least intervention options in diagnosis, treatment and maintenance technology by considering the psychology, health, function and aesthetics of the patient.”8 The MICD concept as the professional movement that encourages all clinicians to select diagnosis, treatment and maintenance modalities that are the least invasive in order to preserve healthy oral tissues while still achieving the natural aesthetics outcome in the best interests of the patient’s health and happiness. Following, I will demonstrate the clinical use of MICD TP (minimally invasive cosmetic dentistry treatmentprotocol)tocloseorreducethediastema in clinical practice (Fig. 1).8 The direct-bonding procedure with the application of the Flowable Frame Technique (FFT) is presented here as a special technique.9 _Case presentation A20-year-oldfemalepatientpresentedwiththe complaint that she did not like her smile because of thelargegapbetweenherupperfrontteeth.Thepa- tientwasveryconcernedabouthersmileaesthetics and also aware of her speech difficulties. PhaseI:Understand In the first step of Phase I, the patient’s percep- tion,lifestyle,personality,anddesireswereexplored in a personal interview and through completion of the MICD self smile-evaluation form. The patient, Fig. 4_Injection of flowable resin to create frame. Fig. 5_Flowable resin ready for light curing. Fig. 6_Plastic strip is removed after light curing; note beautiful lingual frame. Fig. 7_Lips at rest; note MD is clearly visible. Fig. 4 Fig. 5 Fig. 6 Fig. 7