OrthodonticsDOI 10.5005/jp-journals-10015-2716

Fixed Orthodontic Approaches for Midline Diastema: A Comparative Study

This clinical study compares a novel S-spring appliance with conventional elastomeric chains for midline diastema closure in adult patients. The findings highlight more controlled tooth movement and reduced mesial crown tipping with the S-spring over a 12-month evaluation period.

Dr. Zainab Rangwala

Dr. Zainab Rangwala

Chief Dentist · GDCHJ

2 min read26,972 views
  • biomechanics
  • professional education
  • tooth movement
  • dentistry
  • midline diastema
  • fixed appliances
  • Orthodontics
  • Clinical & Academic Article

Abstract

This clinical study compared midline diastema closure using a novel S-spring appliance and conventional elastomeric chains in 40 adult patients. Tipping and torque changes in the maxillary central incisors were evaluated over 12 months. The S-spring achieved diastema closure with better control of tooth movement and reduced mesial crown tipping compared to elastomeric chains. The findings support its use as a more biomechanically favorable option in routine clinical practice.

Midline diastema continues to be one of the most noticeable spacing concerns in adult patients, and many seek treatment primarily for aesthetic confidence. Elastomeric chains are still commonly used for space closure, but clinicians are well aware of their biomechanical limitation — they often produce unwanted mesial crown tipping of the maxillary central incisors during correction.

A recent clinical study evaluated a newly designed S-spring appliance as an alternative approach and compared its performance with conventional elastomeric chains in patients undergoing fixed orthodontic treatment. A total of 40 adult patients with midline diastema were divided into two groups: one group treated with elastomeric chains and the other with the novel S-spring. Tipping and torque changes in both maxillary central incisors were measured at baseline and again after 12 months of treatment.

In the elastomeric chain group, the post-treatment angulations showed greater mesial crown tipping, consistent with the commonly observed force pattern of chain-based space closure. In contrast, patients treated with the S-spring demonstrated lower tipping values and better control of torque, resulting in crown positioning that was more closely aligned to the tooth’s long axis. The differences between the two groups were statistically significant, indicating a meaningful biomechanical advantage with the S-spring.

From a clinical perspective, the findings suggest that while elastomeric chains are efficient for space closure, they may require additional finishing mechanics to correct unwanted tilting. The S-spring, by distributing forces more favorably, supports more controlled and bodily tooth movement from the beginning of treatment, reducing the likelihood of mesial crown tipping and the need for later corrective adjustments.

This makes the S-spring particularly relevant in adult diastema cases where esthetics, root positioning, and long-term alignment stability are important treatment priorities. It may serve as a useful adjunct in routine orthodontic practice, especially in situations where clinicians prefer greater control over incisor movement during space closure.

References

  1. [1]American Association of Orthodontists. Clinical Practice Guidelines American Association of Orthodontists. Available at: source
  2. [2]American Association of Orthodontists. Medically Necessary Orthodontic Care American Association of Orthodontists. Available at: source

Written by

Dr. Zainab Rangwala

Dr. Zainab Rangwala

Chief Dentist · GDCHJ

With over 12 years of clinical experience, Dr. Zainab Rangwala brings a unique blend of clinical expertise and communication excellence to her role as the Media and PR Head at DentalReach. Passionate about bridging the gap between dentistry and digital communication, she plays a key role in shaping the platform’s voice and outreach.