Closing spaces with minimally invasive techniques safeguarding the periodontal aspects
16 Aug 2023 ON-DEMAND Area of interest: General Dentistry, Cosmetic Dentistry, Restorative Dentistry


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Classical dentistry is dealing with defects, caries, demineralized areas, discolorations or broken teeth after trauma. In such indications we are restoring damaged, infected or missing areas of the tooth structure. In order to achieve immediate success and long-term survival we need to respect several biological rules and follow certain clinical protocols. Restoring the function was the priority and aesthetics was secondary. If at the end of the treatment, the restoration looked nice, it was always welcome. The above description fits well with dentistry during the last 30 years. But these ideas are no longer acceptable to many of our patients. In our competitive modern society, it is considered a disadvantage to have “not nice looking” teeth. This means that whenever something happens to them (caries, trauma, insufficient form, proportions or alignment) the situation needs to be fixed… and in an aesthetic way! As a simple example, many patients have had old anterior composites with an insufficient appearance and a diastema for years, they come to you for having them changed plus the diastema closed, and suddenly they do not accept anything but a perfect invisible filling! Others come for orthodontic treatment with too small teeth for their jaws, and after the orthodontic treatment they are not happy with nicely align teeth with spaces between them, they also want to have them closed!

Fortunately, the improvements in techniques and materials have been so great during the last years that we are in a comfortable position to offer the patients answers and predictable results for such cases. Nevertheless, we should never forget that adding any material to the teeth might cause gingivitis, a periodontal pocket, bone loss and or recessions over the long term.

The lecture will focus on dealing with diastema in a simple, minimally invasive and predictable way, always keeping in mind the periodontal aspect. It will also give guidelines regarding the choice of materials and the parameters involved in their design, it will present new digital diagnostic tools and show new prep-less composites and ceramics techniques. It will be based on many fully documented clinical cases in HD quality, with step-by-step procedures, showing what is really possible to achieve and the limitations of novel techniques.

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