Closure of maxillary diastema using ceramic laminate veneers: case report

Abstract

Background. Maxillary diastema represents a common esthetic problem encountered in dental practice, having a significant impact on smile aesthetics, self-esteem and the patient’s social adaptation. In modern dentistry, treatment aims not only at restoring the function of the dento-maxillary system, but also at achieving harmonious dento-facial integration and psychological comfort. In cases where diastema persists into adulthood, therapeutic indications are predominantly esthetic, and the choice of treatment method requires a complex analysis of dental proportions, occlusal relationships, periodontal status and the patient’s expectations. Objective of the study. Closure of diastema through an indirect method using laminate veneers. Material and methods. The study presents the clinical management of a 36-year-old female patient who presented with complaints of an esthetic defect in the anterior region caused by the presence of a divergent diastema on the upper arch of approximately 7 mm. Clinical and paraclinical examination established the diagnosis of Angle class II/1 malocclusion, moderate crowding on the lower arch and divergent maxillary diastema. The patient refused orthodontic treatment and opted for a prosthetic solution with immediate results. The therapeutic protocol included a photographic protocol, 3D intraoral scanning and digital CAD/CAM planning with a diagnostic wax-up to determine the shape and position of the future veneers. Dental preparation was performed minimally invasively within enamel limits. Feldspathic ceramic veneers were digitally designed and milled, and fixation was performed using an adhesive technique including acid etching, silanization and dual-cure composite cement. Results. The treatment allowed the closure of the diastema and restoration of dental proportions, achieving a harmonious esthetic integration of the smile. Correct marginal adaptation, color stability and the optical properties of the ceramic contributed to obtaining a predictable and durable esthetic result. Conclusions. Ceramic laminate veneers represent a minimally invasive and predictable method for closing diastema in the anterior region. The integration of CAD/CAM digital technologies in diagnosis and treatment planning increases precision, predictability of the outcome and patient satisfaction, contributing to long-term esthetic and functional rehabilitation.