The Prevalence and Gender Distribution of Midline Diastema among Patients Attending A Private Dental College - An Original Study
Rinieshah Nair R. Baskran1, Nivethigaa B2*, Balaji Ganesh S3
1 Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India.
2 Senior Lecturer, Department Of Orthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India.
3 Senior Lecturer, Department of Periodontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India.
*Corresponding Author
Nivethigaa B,
Senior Lecturer, Department Of Orthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077,
Tamil Nadu, India.
Tel: +919524234613
E-mail: nivethigaab.sdc@saveetha.com
Received: July 30, 2021; Accepted: August 11, 2021; Published: August 18, 2021
Citation:Rinieshah Nair R. Baskran, Nivethigaa B, Balaji Ganesh S. The Prevalence and Gender Distribution of Midline Diastema among Patients Attending A Private Dental College - An Original Study. Int J Dentistry Oral Sci. 2021;8(8):4124-4127. doi: dx.doi.org/10.19070/2377-8075-21000842
Copyright:Dr. Nivethigaa. B©2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
Diastema is the space between adjacent teeth. Midline diastema of midline diastema have been documented which includes transient malocclusion, abnormal frenal attachment, proclination, midline pathology, iatrogenic cause and racial predisposition. Midline diastema can be managed by means of removal of cause, active treatment and retention. The aim of this study was to evaluate the prevalence of midline diastema among the Chennai population visiting a private dental institute. Data collection was done in a university setting. A total of 41190 patients were reviewed from the time period of June 2019 to March 2020. Patient records were examined, and the study parameters were listed. The total number of patients with midline diastema, along with their ages and genders were collected. Excel tabulation and SPSS Version 22 was used for data analysis. Chi square test was done to analyse the data. There was statistical significance between the variables that included age, gender and individual orthodontic variation. Midline diastema is more prevalent among the male population, specifically among 24-26 years of age.
2.Introduction
3.Conclusion
4.References
Keywords
Anterior Spacing; Midline Diastema; Prevalence.
Introduction
Midline diastema refers to anterior midline spacing which is greater
than 0.5mm, between both the central incisors be it maxillary or
mandibular teeth [1]. It is usually part of the dental development
during the mixed dentition period, known as the ugly duckling
stage [2]. However, there are several reasons for the occurrence
of midline diastema in the post development stages [3]. They include
arch length discrepancy where conditions such as missing
teeth, peg-laterals and microdontia affect the midline spacing [3,
4].
Another reason includes abnormal frenal attachment [3, 5]. A
thick labial frenal attached at the extent of the papilla, exceeding
the papillary and the papilla penetrating will lead to midline space
discrepancy. Proclination due to oral habits like thumb sucking
can cause midline diastema along with generalised spacing [3, 6].
Midline diastema can be diagnosed by a few characteristic traits.
The first is a direct visualisation of the space seen in the anterior
region [7]. Secondly, blanching of the tissue in the incisive papilla
region palatal central incisor when the labial soft tissue stretched
[8]. Subsequently, the discrepancy by measuring the mesiodistal
width of the teeth [9]. The more subtle way of diagnosing includes
observation of spacing in the interdental alveolar bone
seen via a periapical radiograph and revealing the presence of any
existing pernicious oral habits [4, 10].
Midline diastema can be managed by various methods. The first
line of treatment would be the removal of cause [11]. Based on
the patient’s clinical history, the etiological factor should be eliminated
[12]. For instance, if oral habits were identified, habit breaking
appliances can be suggested [12, 13]. However, in case of a
mixed dentition phase, no specific treatment is required as it is
self-correcting with the eruption of permanent canines[14].
The same line of treatment doesn’t apply for high frenal attachment;
it is advised that the midline diastema should be corrected
as much as possible before frenectomy can be done [15]. This
reduces the formation of scar tissue, which otherwise can result
in impeding the progress of space closure [15, 16]. Peg laterals
if present can be treated by means of prosthetic or orthodontic
orthodontic correction [17].
Another method of correction includes the application of reciprocal
anchorage by providing a removable or fixed appliance, depending
on the severity of midline diastema [6]. Cosmetic restoration
using aesthetic composite resin can also aid in correcting mild
diastema in adults. Prosthetic restoration can also be advised. This
study provides a different epidemiological approach among our
population. Previously our team has a rich experience in working
on various research projects across multiple disciplines. [18, 32].
Now the growing trend in this area motivated us to pursue this
project. This study was done to evaluate the incidence of midline
diastema among the South Indian Population.
Materials and Methods
This study was based on a university setting where case records of
patients who visited the institution from June 2019 to March 2020
were analysed. Case sheets of the patients were reviewed individually,
and the data was cross-verified by another examiner to bias
Overall case records of 41190 patients were evaluated. Following
age sorting of patient details within the range of 18-35 years,
the final sample was obtained which included records of 17153
patients. The data was further analysed to obtain the total number
of patients with midline diastema. Incomplete or missing data has
been eliminated.
Parameters considered in the tabulation were age, gender and
presence of midline diastema. SPSS Version 22 was used to import
and analyse the data. Chi-square test was done to evaluate
the statistical significance of the values obtained. The dependent
variables included midline diastema.
Results & Discussion
The following were the results obtained from the analysis:
Table 1, Figure 1 shows the cross-tabulation between age and
midline diastema. Patients were segregated between the ages 18-
35. 24-26 had the highest number of prevalence in terms of midline
diastema - 20 patients. The least number of patients between
the ages of 33-35 showed the least prevalence - 7. The results
were statistically significant between age and individual orthodontic
variation based on the Chi-square test. (p-Value < 0.05).
Table 2, Figure 2 shows the cross-tabulation between gender and
midline diastema. Out of 17153 patients, 8352 were male patients
while 8801 were female patients. 908 male patients had individual
orthodontic variation. Out of which 53 patients had midline diastema.
602 female patients had individual orthodontic variation.
Out of which 32 of them had midline diastema. Based on the
statistics obtained, the male population was proven to be more
prevalent than the female population. The results were statistically
between gender and individual orthodontic variation based on the
chi-square test. (p-value <0.05).
This study showed the association between age, gender and presence
of midline diastema. The above results showed association
with all the parameters, it's significant value and corresponding
statistics in the form of bar charts.
The overall prevalence of midline diastema among the population
visiting Saveetha Dental College was noted to be 0.49%. The frequency
of occurrence was higher among males(53) than females
(32). In this study, we have observed that there was significant association
between age, gender and presence of midline diastema.
Patients were segregated based on age ranging from 18-35 years.
Figure 1 shows age versus midline diastema. Midline diastema was
highly prevalent among patients between the ages 24-26 years of
age. This can be attributed to the fact that in most of the cases,
midline diastema even if it is un-esthetic, is left unnoticed and
diagnosis is done when the patient reports later in adult age when
other dental problems coexist[33]. It may be also due the etiological
factors and hereditary reasons [34]. Most young adults have retained
midline diastema due to pre-existing factors that developed
during the mixed dentition period [35].
We also observed that there was a significant association between
gender distribution in the presence of midline diastema. Figure
2 shows gender distribution in the presence of midline diastema
where it was proven to be specifically significant in male population
compared to females. The initial male to female ratio was
not standardized therefore a general conclusion cannot be drawn.
This also can be attributed to the genetic predisposition and ethnicity
[4].
In another study conducted by Umanah A et al, a contradictory
result was obtained where the female population had higher
prevalence than the male population in the occurrence of midline
diastema [36]. Zahrani et al, detected that it was a common occurrence
that female patients seek treatment of the midline diastema
due to aesthetic concern than the male patients [37]. Our institution
is passionate about high quality evidence based research and
has excelled in various fields [38-48]. We hope this study adds to
this rich legacy.
The limitation of this study is the specific data that needed to be
collected in a restricted sample size. Therefore it cannot be generalised
to a larger population. Futuristically, the study population
should be made larger. A prospective study on midline diastema
with emphasis on etiology should be conducted to better conclude
this study.
Figure 1. Bar graph represents the age distribution in the presence of midline diastema where pink represents 18-20 years old, yellow represents 21-23 years old, green represents 24-26 years old, red represents 27-29 years old, brown represents 30-32 years old and blue represents 33-35 years old. X-axis represents age distribution and Y-axis represents the number of patients with midline diastema. Almost in all age groups, the presence of midline diastema has been detected. It is highest among 21-23 years of age and lowest among 18-20 years of age.
Figure 2. Bar graph represents the gender distribution in the presence of midline diastema where black represents male and purple represents female. X-axis represents gender distribution and Y-axis represents the number of patients with midline diastema. The occurrence of midline diastema among male patients is higher compared to female patients with midline diastema.
Figure 3. Bar graph represents the gender distribution between different age groups where black represents male and purple represents female. X-axis represents age groups and Y-axis represents the number of patients. The occurrence of midline diastema among male patients is higher (15.29%) specifically between ages 21-26, and lower among female patients with midline diastema (4.12%) specifically between ages 33-35. (Chi square value 14.967, p value= 0.0015-statistically significant).
Conclusion
Within the limits of this study, midline diastema was found to
be more prevalent among the male population; however the results
of the study cannot be applied for the entire population due
to the lesser sample size within the given geographical location.
Extensive research including more diverse populations can give
conclusive evidence regarding the presence of midline diastema
in various populations.
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