Stability of Midline Diastema Closure by Frenectomy and Orthodontic Treatment: A Systematic Review

Introduction: Midline diastema is one of the most common aesthetic complaints in mixed and sometimes in permanent dentition stage. High frenal attachment is the major aetiological factor causing midline spacing. Combined frenectomy and orthodontic treatment can be done to close the midline diastema which may also increase the stability and reduce relapse. Aim: To assess the stability of midline diastema closure by using frenectomy and orthodontic treatment. Materials and Methods: A systematic review was conducted about clinical trials showing the stability of midline diastema closure by using frenectomy and orthodontic treatment, articles were searched from 1995 to 2022. A total of 521 articles were retrieved. Among these 433 articles were screened. The risk of bias was assessed for all the studies included in this review. Results: A total of five studies were included in the systematic review which has clinical trials showing the stability of midline diastema closure in patients having midline diastema of at least 0.5 mm. Four studies using orthodontic treatment has shown some amount of relapse and one study using orthodontic treatment and frenectomy has shown prominent closure of median diastema. Conclusion: Closure of maxillary median diastema is more prominent when it is performed by using combined frenectomy and orthodontic treatment than orthodontic treatment alone and the risk of relapse is minimal. However, furthermore clinical studies are required to confirm the stability of midline diastema closure by using orthodontic treatment and frenectomy.