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Management of Midline Diastema Using Removable Orthodontic Appliances Combined with Frenec-tomy: A Case Report Setiawan, Irfan Maulana Aji; Syahputri, Regina Meilin; Kurniasari, Reni
Interdental Jurnal Kedokteran Gigi (IJKG) Vol. 22 No. 1 (2026): Interdental Jurnal Kedokteran Gigi (IJKG)
Publisher : Fakultas Kedokteran Gigi, Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46862/interdental.v22i1.12666

Abstract

Introduction: A midline diastema is a gap between the maxillary central incisors that can lead to aesthetic, psychological, and social issues. Its etiology is multifactorial, with one contributing factor being a high-attachment superior labial frenulum, which may cause relapse following orthodontic treatment. Case: A 22-year-old female patient presented with the chief complaint of a 1.5 mm gap between her upper front teeth, which significantly disturbed her appearance. The patient also had a habit of biting pencils and a history of relapses after previous orthodontic treatment. Case Management: The patient was treated with removable orthodontic appliances consisting of active maxillary and mandibular plates. The active components included finger springs, a labial arch, and continuous springs, which were gradually activated during each follow-up visit. At the eighth follow-up visit, a frenectomy was performed at the Department of Periodontics due to the high attachment of the superior labial frenulum, which posed a potential risk for relapse. Removable orthodontic appliances have been reported to be effective in closing mild to moderate midline diastema, particularly through the tipping movement of anterior teeth. Patient compliance, controlled activation, and appropriate appliance design are critical determinants of success. Frenectomy also contributes to the stability of the outcome by eliminating soft tissue tension that could potentially reopen the diastema gap. Conclusion: The combination of removable orthodontic treatment, frenectomy, and a retention phase with a retainer can yield optimal results in midline diastema cases. Comprehensive evaluation of etiological factors, patient adherence, and long-term monitoring are strongly recommended to prevent relapses.
Direct Fiber-Reinforced Composite Onlay for Post-Endodontic Restoration of the Maxillary First Pre-molar Syahputri, Regina Meilin; Widyastuti, Noor Hafida; Cahyani
Interdental Jurnal Kedokteran Gigi (IJKG) Vol. 22 No. 1 (2026): Interdental Jurnal Kedokteran Gigi (IJKG)
Publisher : Fakultas Kedokteran Gigi, Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46862/interdental.v22i1.12668

Abstract

Introduction: Pulp necrosis is a pathological condition of the dental pulp that requires root canal treatment. Post-endodontic restoration is required to support the success of the root canal treatment, restore dental function, and improve aesthetics. In this case, the final restoration employed was a direct composite onlay with fiber reinforcement. Case: A 30-year-old female patient presented to the Dental Hospital of Soelastri, Universitas Muhammadiyah Surakarta (UMS), with a chief complaint of a carious tooth on the upper right jaw, which had been present for the past year. The diagnosis was established based on subjective, objective, and supplementary examinations. The diagnosis was pulp necrosis with apical periodontitis in tooth 14. Case Management: The patient underwent root canal treatment in accordance with the principles of the endodontic triad. Subsequently, the final restoration was placed as a direct composite onlay with fiber reinforcement. Discussion: A direct composite onlay with fiber reinforcement is a restoration that can be utilized following root canal treatment. The advantages of this restoration include its resistance to masticatory forces, favorable aesthetics, and color resemblance to dentin. Conclusion and Suggestions: Restoration after root canal treatment is crucial to ensure the success of the endodontic therapy. The use of a direct composite onlay with fiber reinforcement represents one of the options for the final restoration following root canal treatment.