Digital Smile Design- Dr. Amr Abdelrahem
Diastema Closer with direct composite under DSD Protocol

Femail patient present to clinic with a central diastema about 3mm, and asking for close the diastema with direct composite as temporary solution, it hard to make a decision in 3mm diastema even with ceramic restoration, before thinking in what we can do in diastema and shifting, we need to make a frenectomy to make a space and form an embrasure between centrals after shifting.

So first of all, take preoperative shots, impression:


frenectomy procedure

removal of soft tissure

sutureing and follow up

Now here is a study cast for this case, the only solution to close diastema with proper guidelines is using DSD as showin

according to dsd guidelines, first step is recording the correct facial guidance, equalize the correct midline, then chose a proper smile line as showin

choose the proper shape of teeth then match it with case guidance “midline and smileline”

Digital equation of midline shifting and tooth elongation, we found about 1.5mm meisally to centrals, 1.5 distally to centrals, 1mm mesially to laterals, 1mm distally to laterals, and 1.5mm elongated centrals incisally

Free hand waxing up related to records

second visit after 1 week of frenectomy surgery

Tissue formation and papilla relapse

Preparation accordin to dsd guides,

Proper isolation

Step of indirect restoration and making palatal shell, using palatal index guided with waxing up on dsd guides

Soft tissue healing after 2 weeks follow up

Final result


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