Fechamento de diastemas: uma revisão sobre as diferentes técnicas restauradoras

Abstract

Diastemas are a common clinical condition characterized by interdental spaces that can compromise aesthetics and function. Their etiology is multifactorial, including factors such as dental anomalies, parafunctional habits, and periodontal alterations. Several restorative techniques are available for diastema closure, with different indications, advantages, and limitations. Therefore, the objective of this literature review was to describe and critically analyze the different therapeutic approaches for diastema closure, with an emphasis on direct (composite resin) and indirect (laminates and ceramic fragments). To this end, a narrative review of the literature was conducted, based on scientific articles, books, and case reports published between 2011 and 2023, using databases such as PubMed, Scielo, and Google Scholar. The articles used as references for this study revealed that direct composite resin restorations, especially those with diagnostic wax-up and BRB (Bertholdo/Ricci/Barrotte) matrix, stand out for their tissue conservation, reduced cost, and the possibility of being performed in a single appointment. Indirect techniques, such as ceramic laminates (0.2–0.7 mm thick) and ceramic fragments, offer greater strength and color stability, but require laboratory steps and a greater investment from the patient. Technical factors such as diastema size, patient expectations, periodontal health, and occlusion type should be considered when selecting the restorative technique. Both approaches provide satisfactory results, and the choice of restorative technique will depend on individual clinical criteria. Finally, it can be observed that direct restorations were considered ideal for minimal and conservative corrections, while indirect techniques were preferable for complex cases or those with high aesthetic demands. Therefore, a combination of methods may be necessary in specific situations, such as diastemas associated with color or shape changes.