References

Bergstrom, et al. (no abstract available)
Mean size of diastema at start of study: 1.61mm for diastema group; 1.66mm for control; error of the method, 0.04mm. AJO, 63 (6),1973, 633-8.

A prospective study was performed examining two groups of children (20 in each), mean ages 8.8 years in both, (not specific as to gender) had diastemas at least 2mm wide and pulling on the lip resulted in ischemia at the incisive papilla.
- One group randomly selected to be treated with frenectomy and the other simply observed.
- Groups were balanced according to:
- Eruptive state of anteriors
- Inclination of central incisors
- Overbite, overjet and occlusal relationship of anterior teeth
- Amount of crowding in anterior segments
As the graphic demonstrates, ten years after the surgery, there was no difference between the groups.
Graphic to be supplied before 12-1-05

Mean diastema for the two groups were 1.66 and 1.61mm; the surgical group had a more rapid closure, but by age 10 the difference between the groups was negligible.

Shown is the result “achieved” by three frenectomy procedures; each was performed to “close the space.” Regrettably, the net result was an unsightly “black triangle” due to the loss of papilla (1-97) and no space closure.

The periapical x-ray demonstrates the pre-orthodontic condition of the bone between the two central incisors.

Through orthodontics, the space was closed; and a nice esthetic result was achieved (6-98).

Edwards JG.
The diastema, the frenum, the frenectomy: a clinical study. Am J Orthod. 1977 May;71(5):489-508.

1. The pretreatment relationship between a clinically “abnormal”-appearing maxillary midline frenum and a midline diastema showed a strong, but not absolute, correlation. A certain percentage of patients demonstrated (1) a diastema but not an “abnormal” frenum or (2) no diastema but an “abnormal” frenum. 2. Diastema cases in which there were “abnormal” pretreatment frenua demonstrated a decidedly stronger potential for relapse after orthodontic closure. The exceptions to the rule were explained by the clinician’s inability to differentiate between “normal” and “abnormal” frena and by the periodontium’s apparent (if not consistent) ability to recognize the frenal and interdental tissues following orthodontic tooth movement. 3. A three-stage surgical procedure was shown to be very effective in alleviating the relapse phenomenon following orthodontic treatment of diastemas. The surgical procedures were successful in avoiding many of the hazards to the periodontium associated with previous techniques.

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