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Kamalli, M., Deepak, S., & Sandeep, A. H. (2022). Knowledge, practice and attitude on management
of diastema among dental students. International Journal of Health Sciences, 6(S1), 5017–5032.
https://doi.org/10.53730/ijhs.v6nS1.5972
International Journal of Health Sciences ISSN 2550-6978 E-ISSN 2550-696X © 2022.
Corresponding author: Deepak, S.; Email: deepaks.sdc@saveetha.com
Manuscript submitted: 27 Feb 2022, Manuscript revised: 18 March 2022, Accepted for publication: 09 April 2022
5017
Knowledge, practice and attitude on
management of diastema among dental
students
Kamalli. M
Graduate, Saveetha Dental College and Hospitals, Saveetha Institute of Medical
and Technical Sciences, Saveetha University, Chennai-600077, Tamil Nadu,
India.
Email: 151901007.sdc@saveetha.com
Dr. Deepak. S
Senior Lecturer, Department of Conservative dentistry and Endodontics, Saveetha
Dental College and Hospitals, Saveetha Institute of Medical and Technical
Sciences, Saveetha University, Chennai-600077, Tamil Nadu, India.
Email: deepaks.sdc@saveetha.com
Dr Adimulapu Hima Sandeep
Senior lecturer, Department of Conservative Dentistry and Endodontics, Saveetha
Dental College, Saveetha Institute of Medical and Technical Sciences (SIMATS),
Chennai, Tamilnadu, India.
Email: himas.sdc@saveetha.com
Abstract---Introduction: Diastema is a term used in dentistry which
refers to a gap between the teeth. This condition is both common in
children as well as in adults. These gaps can be an aesthetic issue for
individuals when they are highly noticeable. The causes for diastema
can be several reasons like size of teeth, size of jaw bone etc.
Treatment of diastema varies from individual to individual based on
the cause of the condition. Aim: The aim of the study is to determine
the knowledge, attitude and practice about management of diastema
among the dental students. Materials and methods: Self-administered
questionnaire was prepared based on diastema and distributed among
dental students through an online survey link. The sample size was
about 113 undergraduate dental students. The data was statistically
analysed with the SPSS software. Results and Discussion: In the
study, 94.7% of the population were aware about the term diastema
and 5.3% of the population were not aware about the term diastema.
13.3% % of the participants responded that transient malocclusion is
the cause for diastema, 14.2% responded midline pathology, 7%
responded proclination and 65.5% responded as all of the above.
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Conclusion: The present study concludes that the knowledge, attitude
and practice about management of diastema among the dental
students was satisfactory yet more education regarding the recent
advances is necessary.
Keywords---Knowledge, practice, diastema, dental students,
Innovative technique.
Introduction
Diastema is a term used in dentistry which refers to a gap between the teeth. This
condition is both common in children as well as in adults. These gaps can be an
aesthetic issue for individuals when they are highly noticeable. The causes for
diastema can be several reasons like size of teeth, size of jaw bone etc. Certain
oral habits also influence diastema. It is also known that diastema can develop
from periodontal diseases. The inflammation progression affects the gums and
tissue supporting the teeth which eventually leads to loss of teeth. Treatment of
diastema varies from individual to individual based on the cause of the condition.
Diastema is generally aren't preventable but there are possibilities to reduce the
risk of developing diastema.Prevention of habits like thumb sucking, tongue
thrusting, improper swallowing and biting and poor oral hygiene can reduce the
possibility of diastema. Midline diastema is the most common type occurring both
in adults and children (1). Sometimes there can be iatrogenic causes for the
condition. Fixed appliances play a major role in the rapid correction of diastema
by incorporating elastics and springs (2). Retention of midline diastema is often
difficult as there is a feasibility of formation of gaps again (3). The midline
diastema is often influenced by genetic and environmental factors mainly in
primary and mixed dentition period (4) (5). Hereditary relations and patterns also
have their own correlation with midline diastema (6).
Innovative treatment for diastema has been developed in order to restore the
aesthetics which are from procedures like composite build up, frenectomy etc. (7).
This condition requires immediate treatment after observation as they can be
treated and restored easily at the earliest (8). In previous studies it was mentioned
that diastema closure in anterior teeth using recontour of gingiva and composite
restoration was successful (9). There are many advances in treatment for
diastema which enable much easier restoration (4).
Our team has extensive knowledge and research experience that has translate
into high quality publications (10–19),(20–23),(24–28) (29). The aim of this study
is to determine the knowledge, attitude and practice about management of
diastema among the dental students.
Materials and Methods
This was a survey conducted among dental students. Self administered
questionnaire was taken based on management of diastema. The questionnaire
(close ended questions) was circulated through an online survey link. The
questionnaire included demographic data also. SPSS software was used to obtain
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statistical results. Pearson chi square test was done to find the correlation
between year of study and knowledge about diastema. The method of
representation of results was presented by pie charts and bar diagrams.
Results
Figure 1: Pie chart showing the responses for gender of participants where blue
denotes female and green denotes male. 68.14% of the participants were female
and 31.9% were male.
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Figure 2: Pie chart showing the responses for the year of study of participants
where blue denotes female and green denotes male. 33.63% of the participants
were from second year, 29.20% were from third year, 18.58% were from fourth
year, 9.73% from first year and 8.85% were interns.
Figure 3: Pie chart showing the responses for the awareness about diastema
where blue denotes no and green denotes yes. 94.69% of the participants were
aware about the term diastema.
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Figure-4: Pie chart showing the responses for the main cause for diastema where
blue denotes all of the above, green denotes midline pathology, beige denotes
proclination and purple denotes transient malocclusion. 65.49% of the
participants responded to all of the above.
Figure-5: Pie chart showing the responses for the best radiograph to identify the
etiology of diastema where blue denotes bitewing radiograph, green denotes
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intraoral radiograph and beige denotes periapical radiograph. 46.02% of the
participants responded periapical radiograph.
Figure 6: Pie chart showing the responses for the awareness about phases of
treatment for diastema where blue denotes no and green denotes yes. 76.99% of
the participants were aware about the phases of treatment for diastema.
Figure-7: Pie chart showing the responses for the use of fixed appliances in
treatment for diastema where blue denotes no and green denotes yes. 80.53% of
the participants responded that fixed appliances help in treatment for diastema.
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Figure 8: Pie chart showing the responses for the awareness about recent
advances in treatment of diastema where blue denotes no and green denotes yes.
59.29% of the participants were aware about the recent advances in treatment for
diastema.
Figure-9: Pie chart showing the responses for the awareness about composite
buildup where blue denotes no and green denotes yes. 50.44% of the participants
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responded that composite build up acts as efficient treatment for midline
diastema.
Figure 10: Pie chart showing the responses for the awareness about time taken
for treatment of diastema where blue denotes no and green denotes yes. 68.14%
of the participants responded that treatment for diastema takes a prolonged time.
Figure 11: Pie chart showing the responses for the variation in treatment for
diastema where blue denotes no and green denotes yes. 95.58% of the
participants responded that treatment for diastema varies from individual to
individual.
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Figure-12: Bar graph depicting the association between year of study and
knowledge about the main cause of diastema. X-axis represents the year of study
and Y-axis represents the number of participants. The colour blue denotes all of
the above, green denotes midline pathology, beige denotes proclination and purple
denotes transient malocclusion. (Pearson Chi square value-24.711, P-value-
0.016[<0.05]-statistically significant). Out of 113 participants, 6 participants from
the first year, 22 participants from second year, 20 participants from third year,
16 participants from fourth year and 10 participants from interns responded to
all of the above.
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Figure-13: Bar graph depicting the association between year of study and
knowledge about the use of fixed appliances in treatment for diastema. X-axis
represents the year of study and Y-axis represents the number of participants.
The colour blue denotes no and green denotes yes. (Pearson Chi square value-
63.150, P-value-0.00[<0.05]-statistically significant). Out of 113 participants, 27
participants from second year, 33 participants from third year, 21 participants
from fourth year and 10 participants from interns responded that fixed appliances
help in treatment for diastema.
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Figure-14: Bar graph depicting the association between year of study and
knowledge about the use of composite in treatment for diastema. X-axis
represents the year of study and Y-axis represents the number of participants.
The colour blue denotes no and green denotes yes. (Pearson Chi square value-
22.219, P-value-0.00[<0.05]-statistically significant). Out of 113 participants, 21
participants from second year, 14 participants from third year, 11 participants
from fourth year and 10 participants from interns responded that composite
build up acts as an efficient treatment for midline diastema.
68.14% of the participants were female and 31.9% were male (Figure-1). 33.63%
of the participants were from second year, 29.20% were from third year, 18.58%
were from fourth year, 9.73% from first year and 8.85% were interns (Figure-2).
94.69% of the participants were aware about the term diastema (Figure-3).
65.49% of the participants responded to all of the above (Figure-4). 46.02% of the
participants responded periapical radiograph (Figure-5). 76.99% of the
participants were aware about the phases of treatment for diastema (Figure-6).
80.53% of the participants responded that fixed appliances help in treatment for
diastema (Figure-7). 59.29% of the participants were aware about the recent
advances in treatment for diastema (Figure-8). 50.44% of the participants
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responded that composite build up acts as efficient treatment for midline
diastema (Figure-9). 68.14% of the participants responded that treatment for
diastema takes a prolonged time (Figure-10). 95.58% of the participants
responded that treatment for diastema varies from individual to individual
(Figure-11).
Discussion
In the present study, 68.14% of the participants were female and 31.86% of the
participants were male (Figure-1). 33.63% of the participants were from second
year, 29.20% were from third year, 18.58% were from fourth year, 9.73% from
first year and 8.85% were interns (Figure-2).
In the study by Patricia et al., due to increase in demand for facial aesthetics,
awareness about various dental trauma conditions is found to be prevalent
among patients (30). In the study, 94.69% of the population were aware about the
term diastema and 5.31% of the population were not aware about the term
diastema (Figure-3). 13.27% of the participants responded that transient
malocclusion is the cause for diastema, 14.16% responded to midline pathology,
7.08% responded to proclination and 65.49% responded as all of the above
(Figure-4). In the present study, 46.02% of the population answered that
periapical radiograph is the best radiograph to identify the etiology of diastema,
36.28% answered as bitewing radiograph and 17.70% answered as intraoral
radiograph (Figure-5).
76.99% of the population were aware and the remaining 23.01% of the population
were not aware about the phases of treatment of diastema (Figure-6). 80.53%
responded that fixed appliances help in treating diastema and the remaining
19.47% responded that fixed appliances do not help in treating diastema (Figure-
7). In the study by Wesley et al., the clinical report explained the use of computer-
aided design and computer-aided manufacturing (CAD-CAM) composite resin in
closure of a maxillary midline diastema (31). In this study, 59.29% were aware
about the recent advances in closure of midline diastema and 40.71% were not
aware (Figure-8). In the study by William et al., the use of a new silicone index
helped in diastema closure which improves gingival tissue health (32). In the
study by Edina et al., the application of direct restorations provided an excellent
treatment option for closure of diastemas (33).
50.44% of the participants responded that composite build up acts as an efficient
treatment and 49.56% of the participants responded that they are not efficient in
treatment (Figure-9).
In association with the time of treatment of diastema, 68.14% of the participants
answered that the treatment will take a long time and 31.86% of the participants
answered that the treatment will not take a prolonged time (Figure-10). 95.58% of
the participants responded that treatment for diastema varies from individual to
individual and the remaining 4.42% responded that it does not vary (Figure-11).
In the study by Ana et al., the case report showed minimally invasive diastema
treatment due to gingival trauma where it was evident that the cause for diastema
shows variations (34) .
5029
In the association between years of study and knowledge about the main cause of
diastema, out of 113 participants, the majority 22 participants from second year
responded all of the above (Figure-12). In the association between years of study
and knowledge about the use of fixed appliances in treatment for diastema, out of
113 participants, majority 33 participants from third year responded that fixed
appliances help in treatment for diastema (Figure-13). In the association between
years of study and knowledge about the use of composite in treatment for
diastema, out of 113 participants, majority 21 participants from second year
responded that composite build up acts as an efficient treatment for midline
diastema (Figure-14). The limitations of the study is that the survey was
conducted with a limited sample size. This survey can be used as a reference for
future studies with a wider range of population.
Conclusion
The present study concludes that the knowledge, attitude and practice about
management of diastema among the dental students was satisfactory yet more
education regarding the recent advances is necessary.
Acknowledgement
This research was done under the supervision of the Department of Research of
Saveetha Dental College and Hospitals. We sincerely show gratitude to the
corresponding guides who provided insight and expertise that greatly assisted the
research.
Conflicts of Interest
The authors declare that there are no conflicts of interest in the present study.
Source of funding
The present study is sponsored by
● Molequle solutions
● Saveetha Institute of Medical and Technical Sciences
● Saveetha Dental College and Hospitals
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