A 10 year old male patient complains of spacing between his upper front teeth. On clinical examination a midline diastema of 4 mm is seen. It is noted that the patient is in the mixed dentition period. Which of the following is the first line of treatment for this patient?

Frenectomy before orthodontic space closure is contra-indicated due to the formation of scar tissue which may prevent the closure of space. As the age of the patient is 10 years, spontaneous correction could be an option due to the Broadbent phenomenon, however as a general guideline, diastema of more than 4mm is unlikely to resolve spontaneously.  Mesiodens is the most commonly seen supernumerary teeth and a diastema of more than 2 mm at the midline must always be inspected for the same.  A diastema of more than 2 mm should not be closed by tipping of the teeth, rather bodily repositioning is required.