Abstract

A midline diastema, or gap between the maxillary central incisors, is often a normal developmental feature in children but may persist into adulthood, becoming an esthetic concern. This case report presents a 37-year-old female with proclined, discolored maxillary anterior teeth and a long-standing 3 mm midline diastema. The patient was dissatisfied with her smile and exhibited lip incompetency. Radiographic and clinical examinations revealed mild horizontal bone loss and signs of healed anterior infection. Due to the patient’s esthetic concerns, time constraints, and reluctance toward orthodontic treatment, a restorative solution was chosen. The treatment plan involved restoring four maxillary anterior teeth (11, 12, 21, and 22) with multilayer zirconia crowns. Tooth preparation emphasized minimal reduction on the mesial surfaces of 11 and 21 to close the diastema, with more reduction labially to address proclination. A digital workflow using intraoral scanning and CAD/CAM technology facilitated precise design and milling of zirconia crowns, which were then veneered, shade-matched, and cemented with glass ionomer cement. Zirconia restorations provided improved esthetics, biocompatibility, and mechanical strength. This case highlights how zirconia crowns can effectively address esthetic and functional concerns in patients with midline diastema and proclination when orthodontic treatment is not preferred or feasible.

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