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Suggest Treatment For Midline Diastema

Posted on Mon, 19 Oct 2015

Question: Good morning,

I want to have a second opinion.

I have a huge midline diastema of about 7-8mm on lower jaw with excessive gum loss due to the usage of denture in the last 12 years and I want to close it now through orthodontic. Do I go for brace or invisalign? and is it possible to have a denture fixed to the brace or invisalign? thank you

Answered by Dr. Honey Arora (58 minutes later)

Brief Answer:
Denture cannot be fixed to braces.

Detailed Answer:
Hi..
Welcome to HEALTHCARE MAGIC..

I have gone through your query and can understand your concern.

As per your complain and presentation of symptoms midline diastema can be closed with braces as well invisalign but in case if there is gum loss fixing of braces can further cause gum recession and the teeth can become XXXXXXX
So an evaluation of the gum health has to be done by a Periodontist or atleast the correct status of the gum health should be explained by Orthodontist before you can proceed for treatment.

The other part of your question is that can denture be fixed to braces or invisalign?
No, a denture cannot be fixed to the braces or invisalign and even if it is being done by someone, it is probably not a correct treatment protocol.

Keeping in reference to my earlier discussions with you and your present query I would like to advise you that if you have gum recession, better consult a Periodontist and get evaluated and if after a thorough evaluation and checking for mobility if he finds everything al-right you can get the braces placed.

In case if he finds the gums unhealthy he can very well do necessary treatments like Deep Scaling, curettage and even Flap surgery to improve the gum attachment over the teeth [as per the requirement].

If you have any further query you are most welcome.

If you want to ask me a direct question please write @Dr.Honey Arora, Dentist before the question and not only Dr.Arora.

Hope this information helps..

Thanks and regards.
Dr.Honey Nandwani Arora.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Honey Arora (2 hours later)

@Dr. Honey XXXXXXX Dentist

Thanks for your reply and wonderful advice.
I have attached the image of my diastema showing the recedded gum and also frenum.

Do I need the frenum removed before orthodontic treatment or after, i.e after assessing of the gum as you advised in your answer. please advice on this also.

Answered by Dr. Honey Arora (1 hour later)

Brief Answer:
High Frenulum Attachment, Should be removed before braces.

Detailed Answer:
Hi..
Welcome Again..

As per your query as far as gums are concerned from the surface towards the lips the recession does not seems to be recessed neither any inflammation is seen..
Although the gums over the surface towards the gums are always more prone to infection and recession and may be recessed at that surface..
But from the labial surface [surface towards the lips] they does not seems recessed..

As far as frenulum is concerned it is high attachment and for this you should get it removed before the placement of braces for better results of the braces and faster closure of the diastema and not wait for the removal to be done after placement of braces.

If you have any further query you are most welcome.

If your query is resolved please give me a Five star rating and write a positive feedback as a token of encouragement and appreciation..

Hope this information helps..

Thanks and regards.
Dr.Honey Nandwani Arora.

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Honey Arora (26 minutes later)

Thanks. My concern removing the frenum is that it might affect the look of my lip. wont it relapse down?

Answered by Dr. Honey Arora (8 minutes later)

Brief Answer:
It will not affect the look of the lip as well as will not relapse.

Detailed Answer:
Hi.
Welcome Again.

As per your query removal of frenum is a very commonly done procedure and high frenum is seen in many individuals and removal of the frenum does not affect the look of the lip and will although improve the appearance by enhancing the result of Orthodontic Treatment.
It will not relapse and everything will be fine..

If you have any further query you are most welcome.

If your query is resolved please give me a Five star rating and write a positive feedback as a token of encouragement and appreciation..

Hope this information helps..

Thanks and regards.
Dr.Honey Nandwani Arora.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Honey Arora (59 minutes later)

thanks a lot

Answered by Dr. Honey Arora (2 minutes later)

Brief Answer:
Its my pleasure to help!

Detailed Answer:
Hi..
Welcome Again..

If your query is resolved please give me a Five star rating and write a positive feedback as a token of encouragement and appreciation..

Wishing you a Good Health.

Thanks and regards.
Dr.Honey Nandwani Arora.

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Above answer was peer-reviewed by : Dr. Prasad