Using the front wing technique to close a midline diastema

Balraj Sohal introduces a midline diastema closure case, using the 'front wing technique'.

A 53-year-old female attended the clinic concerned about the appearance of her teeth. Improving her smile was her main interest. The patient focused on the aesthetics of her central incisors. She had discussed porcelain veneers with her dentist in the past.

After a thorough assessment and consultation, the patient wanted to focus her efforts on improving the central incisor teeth. Her main concern was the midline diastema and asymmetrical incisal edges.

We informed her that after we close the midline diastema, the central incisors would be more dominant. Therefore we should also consider restoring the lateral incisors to improve the ratios of her centrals and laterals. This would give her a more aesthetically pleasing smile. Due to finances the patient declined this. Instead she asked we focus our efforts on the midline diastema, which we opted to restore with direct composite.

The front wing technique

There are multiple ways to close a midline diastema; using a matrix fabricated from a diagnostic wax up or using the bioclear matrix system to mention a few. In this case we opted to close the diastema using the 'front wing technique'. This is a method taught by Jordi Manuata. It is shaping the composite free hand to develop the emergence profile. Followed by using sectional matrices to develop a refined profile and tight contact point. This technique will be described in this case discussion.

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We place a drop of Venus Shade A2 flowable composite uncured between the upper central incisor and the sectional matrix. Then we place an increment of packable shade A2 composite (to restore the buccal surface) palatally and adapted against the palatal surface of the tooth.

We push the composite very hard against the tooth using...

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