ETIOLOGY OF MIDLINE DIASTEMA IN PATIENTS PRESENTING TO NISHTAR INSTITUTE OF DENTISTRY, MULTAN

OBJECTIVE: To find the different etiological factors underlying a midline diastema which will help in effective orthodontic correction by enabling the practitioner to adopt the most appropriate mechanics. METHODS: This descriptive cross-sectional study was conducted at the Department of Orthodontics, Nishtar Institute of Dentistry, Multan, from 01-08-2020 to 01-02-2021. A sample of 165 patients was analyzed according to age, gender, presenting various occlusal traits, and relevant diastema findings to assess the underlying etiology of the maxillary midline diastema. Cases with a midline diastema of >0.5 mm were documented with examination including clinical intra-oral examination and orthopantomograms and upper occlusal radiographs. Examinations were done by the same observer to reduce human error and were cross-checked by a superior to minimize the possibility of error. The data was analyzed using SPSS version 20.0. RESULTS: Dental anomalies (n=113, 68.6%) was the most frequent cause of maxillary midline diastema. Dental anomalies were observed in both females (n=77/112; 68.8%) and males (n=36/53; 67.9%). Common dental anomalies included tooth/arch size discrepancies (n=58, 51.3%), abnormal occlusal patterns (n=37; 32.7%) and missing teeth (n=18 15.9%). Other contributing factors for maxillary midline diastema observed were abnormal maxillary arch structure (n=30; 18%), physical impediments (n=18; 11%), muscular imbalances (n=3; 1.8%) and pernicious habits (n=1; 0.6%). Common causes of physical impediments were fleshy labial frenum 10/18; 55.6%) and supernumerary tooth (n=8/18; 44.4%). CONCLUSION: Maxillary midline diastema was common in both genders and was associated with multiple etiologies of which dental anomalies, abnormal maxillary arch structure and physical impediments were highly prevalent.