Management Of Maxillary Midline Diastema (MMD) With Removable Orthodontic Appliance
Main Article Content
Abstract
Maxillary midline diastema (MMD) is a space between the middle incisors of the upper jaw which is often an aesthetic problem in adolescents and young adults because it can affect the appearance and decrease the patient's confidence. This condition has a multifactorial etiology, such as genetic factors, high labial frenulum attachment, bad habits of the oral cavity, and impaired growth and development of teeth. In mild diastema cases, the use of removable orthodontic devices can be a treatment option because it is simple, conservative, and effective in correcting the position of the teeth. This case report aims to describe the management of the maxillary midline diastema using removable orthodontic devices. A 19-year-old woman came to the Soelastri Dental and Oral Hospital with a complaint of a gap in the anterior teeth of the upper jaw that interfered with appearance and confidence. Patients also complained that food often got stuck between the teeth and complaints had been felt since high school. The results of the examination showed the presence of a maxillary midline diastema between teeth 11 and 21. Treatment is performed using a removable orthodontic device with an active component of the finger spring for the correction of the central diastema. The patient underwent treatment for 6 months accompanied by regular control and activation of the device. The results of the treatment showed a satisfactory closure of the diastemic space. The use of removable orthodontic devices is effective in correcting mild cases of maxillary midline diastema and can improve the patient's aesthetics and confidence.
Downloads
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
AboulHosn, M., Noujeim, Z., Nader, N., & Berberi, A. (2019). Decompression and enucleation of a mandibular radicular cyst followed by bone regeneration and implant-supported dental restoration. Case Reports in Dentistry, 2019, Article 9584235. https://doi.org/10.1155/2019/9584235
Al, T., & Sugiharto, K. (2025). Tantangan penegakan diagnosis dan tatalaksana bedah kista radikular asimtomatik: Laporan kasus. Jurnal Kedokteran Gigi, 37(3), 400–410. https://doi.org/10.24198/jkg.v37i3.61488
Bane, S. P., Rathi, N. V., Thosar, N. R., & Deulkar, P. V. (2022). Surgical enucleation of radicular cyst in endodontically treated primary mandibular molar. BMJ Case Reports, 15(3), 1–4. https://doi.org/10.1136/bcr-2021-248376
Bonanthaya, K., Panneerselvam, E., Manuel, S., Kumar, V. V., Rai, A., Samson, J., & others. (2021). Oral and maxillofacial surgery for the clinician. Springer. https://doi.org/10.1007/978-981-15-1346-6
Djati, F. K., & Dewi, C. K. (2018). Tatalaksana hematoma akibat trauma. Jurnal Kedokteran Gigi Universitas Jember, 15(2), 26–29.
Firgina, W., & Setyawan, E. (2024). Extraction management of gangrene radix with radicular cyst. Proceeding Improve Quality Dentistry, 1(1), 36–41. https://doi.org/10.18196/imunity.v1i1.5
Lay, S. H., & Supandi, A. (2022). Etiological factors and orthodontic treatment considerations in maxillary midline diastema. World Journal of Advanced Research and Reviews, 15(2), 315–321. https://doi.org/10.30574/wjarr.2022.15.2.0721
Nainar, S. M. H., & Gnanasundaram, N. (1989). Incidence and etiology of midline diastema in a population in South India (Madras). The Angle Orthodontist, 59(4), 277–282. https://doi.org/10.1043/0003-3219(1989)059<0277:IAEOMD>2.0.CO;2
Nair, P. N. R. (2004). Pathogenesis of apical periodontitis and the causes of endodontic failures. Critical Reviews in Oral Biology & Medicine, 15(6), 348–381.
Ogawa, M., Yokoo, S., Yamaguchi, T., Suzuki, K., & Makiguchi, T. (2025). Over ten-year survival rates of radicular cyst-causing teeth and factors affecting long-term outcomes with apical microsurgery: A single-centre retrospective analysis. Cureus, 17(8). https://doi.org/10.7759/cureus.89770
Rios Osorio, N., Caviedes-Bucheli, J., Mosquera-Guevara, L., Adames-Martinez, J. S., Gomez-Pinto, D., Jimenez-Jimenez, K., & others. (2023). The paradigm of the inflammatory radicular cyst: Biological aspects to be considered. European Endodontic Journal, 8(1), 20–36. https://doi.org/10.14744/eej.2022.26918
Romulo, M. G., Santos, P. R., & Villanueva, R. M. (2022). Orthodontic treatment on a patient with maxillary diastema: A case report. International Journal of Medical Dentistry, 26(3), 210–216.
Romulo, M. G., Santos, P. R., & Villanueva, R. M. (2022). Orthodontic treatment on a patient with maxillary diastema: A case report. International Journal of Medical Dentistry, 26(3), 210–216.
Saputra, D. R., Nugraha, A. P., Baydowi, G., Kamadjaja, D. B., & Indiralia, A. (2023). Guided bone regeneration reconstruction of extensive alveolar bone defect due to infected radicular cyst enucleation: Two case reports. International Journal of Surgery Case Reports, 106, Article 108280. https://doi.org/10.1016/j.ijscr.2023.108280
Setiawan, A., Pratiwi, D., & Nugroho, R. (2025). Management of maxillary midline diastema using removable orthodontic appliance: A case report. Interdental Journal of Dentistry, 21(1), 45–52.
Setyawan, E. (2017). Gambaran pola densitas kista radikuler pada sisa akar dengan cone beam computed tomography (CBCT). Insisiva Dental Journal, 6(1), 109–110.
Siahaan, S. M., & Kesuma, H. P. (2025). Laporan kasus: Ekstraksi open method disertai kista radikular pada regio gigi 24. Stomatognatic: Jurnal Kedokteran Gigi, 22(1), 85–88. https://doi.org/10.19184/stoma.v22i1.53703
Tadros, S., Abbassy, M. A., & El-Bialy, T. (2022). Maxillary midline diastema: Aetiology, diagnosis and treatment modalities. Dental Press Journal of Orthodontics, 27(2), 1–12. https://doi.org/10.1590/2177-6709.27.2.e222145.oar
Tadros, S., Abbassy, M. A., & El-Bialy, T. (2022). Maxillary midline diastema: Aetiology, diagnosis and treatment modalities. Dental Press Journal of Orthodontics, 27(2), 1–12. https://doi.org/10.1590/2177-6709.27.2.e222145.oar
Utari, N. P., Rahmawati, D., & Sari, I. M. (2024). Effectiveness of removable orthodontic appliances in mild malocclusion treatment: A literature review. Proceedings of International Meeting of Dental Science, 3(1), 55–61.
Utari, N. P., Rahmawati, D., & Sari, I. M. (2024). Effectiveness of removable orthodontic appliances in mild malocclusion treatment: A literature review. Proceedings of International Meeting of Dental Science, 3(1), 55–61.
Wang, J., Yao, Q. Y., & Zhu, H. Y. (2022). Efficacy of bone grafts in jaw cystic lesions: A systematic review. World Journal of Clinical Cases, 10(9), 2801–2810. https://doi.org/10.12998/wjcc.v10.i9.2801
Wu, Y. H., Wu, Y. C., Sun, A., & Chiang, C. P. (2022). Radicular cyst with features mimicking a verruciform xanthoma. Journal of Dental Sciences, 17(3), 1425–1427. https://doi.org/10.1016/j.jds.2022.04.003