Occurrence of Maxillary Central Diastema between Tooth-supported and Implant-supported Prostheses: a 5-year Clinical Follow-up.

A 27-year-old patient with a history of maxillary anterior tooth trauma presented with a maxillary central diastema between tooth- and implant-supported prostheses that had been in use for 5 years. The all-ceramic crowns were placed in 2012 after rigorous occlusal adjustment. Evaluations were carried out at 0, 2, 3, 4 and 5 years post restoration. The central diastema between the natural teeth and the implant-supported prosthesis on teeth 11 and 12 was first observed 2 years after implantation. After 5 years, the distance was found to have increased, with anterior occlusion and esthetic changes having taken place. The following possible causes were discussed: occlusal problems, anterior traumatic effects, the possible impact of guided bone regeneration (GBR) on the adjacent natural teeth and natural movement. More predictive information should be given to patients with implant-supported prostheses and natural teeth so that they are fully informed of the impact of any necessary clinical compromise and are aware of the modifications that may occur to their natural dentition.