Original Article |
Desislava A. Konstantinova‡, Dimo K. Nedelchev‡, Anna K. Nenova-Nogalcheva‡
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Corresponding author: Desislava A. Konstantinova ( dr.konstantinova@gmail.com ) © 2024 Desislava A. Konstantinova, Dimo K. Nedelchev, Anna K. Nenova-Nogalcheva.
This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Citation:
Konstantinova DA, Nedelchev DK, Nenova-Nogalcheva AK (2024) Retrospective epidemiological study of the width of maxillary diastema in patients from northeastern Bulgaria. Folia Medica 66(4): 500-504. https://doi.org/10.3897/folmed.66.e128602
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Abstract
Introduction: A maxillary diastema (MD) is identified when the gap between the central incisors exceeds 0.5 mm. It poses an a and phonetic concern, often seen in mixed dentition and occasionally continuing into permanent dentition.
Aim: The aim was to conduct a retrospective study on the epidemiology of maxillary diastema among patients in northeastern Bulgaria.
Materials and methods: We analyzed 149 diagnostic plaster models of individuals with maxillary diastema with a mean age of 39.50±1.70 years. To ensure accuracy, we divided the patients into two age groups. People 35 years of age or younger were in the first age group. The second group consisted of those who were older than 35.
Results: Size of maxillary diastema according to sex: the derived 95% confidence interval shows that in the group of patients who met the selection criteria in the study, with 95% certainty, the width of the maxillary diastema was expected to be in the range of 1.389 mm to 1.754 mm. The median maxillary diastema width in males was 1.45±0.78 mm. The median maxillary diastema width in females was 1.41±0.24 mm.
Size of maxillary diastema according to age: data analysis indicates that the average size of a maxillary diastema was 1.43±0.24 mm among those under 35. In such individuals, the maxillary diastema width ranged from 1.07 mm to 2.20 mm, with 1.07 mm being the lowest recorded value. Maxillary diastema in those over 35 had a maximum measurement of 7.88 mm and a minimum of 1.05 mm.
The median width of maxillary diastema in the analyzed 149 models was 1.46±0.23 mm.
Conclusion: Patients’ smiles and dental as are subject to the strict a standards set by modern society. This causes one to examine small details like the distance between one’s central incisors and feel compelled to have them adjusted. Examining the maxillary diastema width in relation to age and sex facilitates a prompt selection of materials and fabrication methods, leading to outstanding functional and a results from the treatment that is performed.
Keywords
a and phonetic issue, maxillary diastema, permanent dentition
Introduction
Maxillary diastema (MD) occurs when the gap between the central incisors exceeds 0.5 mm. It is an a and phonetic issue that is most usually seen in mixed dentition but less frequently occurs in permanent dentition. It is caused by pathogenic and iatrogenic conditions, as well as those affecting jaw growth. Many researchers have investigated the frequency of MD in the community, yielding results ranging from 1.60% to 25.40% in various populations. There is no consensus on the findings of epidemiological studies because the definition of MD varies and there are numerous factors influencing its prevalence.[
Aim
We conducted a retrospective study to investigate the epidemiology of maxillary diastema in patients from northeastern Bulgaria.
Materials and methods
The study was carried out in accordance with the guidelines of the Medical University’s Ethics Committee in Varna, Bulgaria (No. 116/28.04.2022). For this investigation, 149 diagnostic plaster models of individuals with maxillary diastema were examined. All subjects sought dental care from specialized prosthodontic offices due to a concerns. The investigated patients had a mean age of 39.50±1.70 years. The study included 73 male models (mean age: 45.64±1.92) and 76 female models (mean age: 33.59±2.04 years). For accurate analysis, the patients were separated into two age groups. The first age group consisted of people aged 35 and under. In the second category, we included patients over 35 years.
The selection of models was carried out according to the criteria for inclusion in the experimental study (Table
To obtain the plaster models, impressions were taken using condensation silicone impression material (Zeta Plus Putty and Oranwash, Zhermack, Italy), to overcome the retention of intact frontal teeth with maxillary diastema. To neutralize the negative effect of polymerization shrinkage, the plaster models were left to set for up to three hours from the moment the impressions were taken, following the manufacturer’s instructions. The models were cast with class IV gypsum (WellsaStone IV, Wellsamed, Germany), using the reverse pouring method. For maximum precision, a digital caliper Microtech BIG SCREEN, IP54, 300 mm, 0.01 mm, certified for calibration No. M2212-1941 dated 19.12.2022, was used. The distance was measured between the most prominent points on the mesial approximal surfaces of the central incisors. The width of the frontal teeth was recorded as the greatest distance between the mesial and distal contact points, in a plane perpendicular to the longitudinal axis of the tooth being measured. To justify our decision to conduct the retrospective study on plaster models, we examined the obtained data on the width of the MD from 50 patients, measured intraorally, on plaster models, and on a virtual working models. The obtained values for the width of the MD from 50 patients, measured intraorally, on a plaster model, and on a digital diagnostic model, did not show a statistically significant difference (p=0.000) (Fig.
| Inclusion criteria | Exclusion criteria |
| Age between 18 and 65 years | Age under 18 and over 65 years old |
| Presence of maxillary diastema | Presence of periodontal disease |
| Intact frontal teeth | Presence of erosion, attrition, and abrasion on the frontal maxillary teeth |
| Physiological occlusion | Pathological occlusion |
| Caucasian race | Negroid or Mongoloid race |
| Absence of parafunctions | Presence of parafunctions |
| Absence of systemic diseases | Presence of systemic diseases |
Results
Size of MD according to sex
The derived 95% confidence interval shows that in the group of patients who met the selection criteria in the study, with 95% certainty, the width of the MD was expected to be in the range of 1.389 to 1.754 mm. According to the data from the studied models, the average value of the MD size in males was 1.57±0.78 mm. The median of the MD width in males was 1.45±0.78 mm. The smallest measured value of the MD in males was 1.09 mm, and the largest was 7.88 mm.
The analysis of the results in females shows an average value of MD of 1.43±0.24 mm and a 95% confidence interval of 1.37 to 1.48 mm. The median MD width in females was 1.41±0.24 mm. This value is remarkably close to the value obtained for males. The smallest measured value of MD in females was 1.05 mm, and the largest was 2.34 mm. The obtained standard errors were negligibly small, ensuring the reliability of the results and allowing the generalization that at the lower limit, the value of the measured MD widths in both sexes in the studied group was very close (males: 1.38 mm; females: 1.37 mm).
Size of MD according to age
The analysis of the data shows that in individuals ≤35 years old, the average size of MD is 1.43±0.24 mm. The derived 95% CI indicates that patients from northeastern Bulgaria, meeting the inclusion criteria for the study, are characterized by MD widths ranging from 1.37 to 1.50 mm. The value of the median MD width in the studied group is 1.41±0.24 mm. The smallest measured value of MD width in individuals ≤35 years old is 1.07 mm, and the largest is 2.20 mm.
Individuals over 35 years old had an average MD size of 1.544±0.72 mm, with a 95% confidence interval ranging from 1.391 to 1.696 mm. The median MD width among these participants was 1.44±0.72 mm. The smallest measured value of MD in those over 35 years old was 1.05 mm, while the maximum was 7.88 mm.
The median value for the 149 models evaluated was 1.46±0.23 mm. The data analysis revealed no linear correlation between the age of the examined units and the size of the MD. Thus, non-parametric correlation coefficients were applied. After evaluating the results, a Kendall’s tau coefficient of 0.123 (significant at α=0.05) and a Spearman’s rank correlation coefficient of 1.148 (significant at α=0.05) were found. A positive but weak correlation was found between the age of the examined patients and the size of MD. The diastema widens with age.
Discussion
The processed data from our study show that the average size of MD in the studied male patients (1.57 mm) was larger than that in the studied female patients (1.43 mm). Similar results were also reported by Sękowska and Chałas.[
Conclusion
Today’s society places a high value on patients’ dental as and smiles. This leads to a focus on tiny details such as the distance between central incisors and a desire to fix them. Despite the availability of many procedures, prosthetic methods remain preferred due to the long-term nature of treatment, ease of execution, and predictable results. Studying the width of MD based on sex and age allows for a rapid selection of materials and construction procedures, resulting in superior functional and a outcomes from the treatment.
Acknowledgements
The authors have no support to report.
Funding
The authors have no funding to report.
Competing Interests
The authors have declared that no competing interests exist.
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