title: Does the maxillary midline diastema close after frenectomy?
abstract: OBJECTIVE
  To analyze the closure, persistence or reopening of the maxillary midline diastema after frenectomy in patients with and without subsequent orthodontic treatment.
  
  
  METHODS
  All patients undergoing frenectomy with a CO2 laser were included in this retrospective study during the period of September 2002 to June 2011. Age and sex, the dimension of the diastema, eruption status of the maxillary canines, and the presence of an orthodontic treatment were recorded at the day of frenectomy and during follow-up.
  
  
  RESULTS
  Of the 59 patients fulfilling the inclusion criteria, 31 (52.5%) had an active orthodontic therapy, while 27 (45.8%) had a frenectomy without orthodontic treatment. For one patient, information concerning orthodontic treatment was not available. In the first follow-up (2 to 12 weeks), only four diastemas closed after frenectomy and orthodontic treatment, and none after frenectomy alone. In the second follow-up (4 to 19 months), statistically significantly (P = .002) more diastemas (n = 20) closed with frenectomy and orthodontic treatment than with frenectomy alone (n = 3). At the long-term (21 to 121 months) follow-up, only four patients had a persisting diastema, and in three patients orthodontic treatment was ongoing.
  
  
  CONCLUSIONS
  Closure of the maxillary midline diastema with a prominent frenum is more predictable with frenectomy and concomitant orthodontic treatment than with frenectomy alone. This study demonstrates the importance of an interdisciplinary approach to treat maxillary midline diastemas, ideally including general practitioners, oral surgeons, periodontists, and orthodontists.
authors.forename: Valerie G A
authors.initials: VG
authors.lastname: Suter
authors.forename: Annik-Emily
authors.initials: AE
authors.lastname: Heinzmann
authors.forename: Johannes
authors.initials: J
authors.lastname: Grossen
authors.forename: Anton
authors.initials: A
authors.lastname: Sculean
authors.forename: Michael M
authors.initials: MM
authors.lastname: Bornstein
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003970:Diastema / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007742:Labial Frenum / Q000601:surgery*; D053685:Laser Therapy; D008297:Male; D008437:Maxilla; D055815:Young Adult