Purpose: Midline diastema due to simultaneous interplay of mesiodens and thumb-sucking habit is a very uncommon situation and can represent negative impact on esthetics and function. The purpose of this article is to describe a case report of a 9 year-old boy with a 9-mm midline diastema and an anterior open bite treated with an interceptive orthodontic approach.Case Description: After orthodontic diagnosis, treatment undertaken was the surgical removal of the mesiodens and the use of a palatal crib therapy in order to discontinue the thumb habit. Then, orthodontic brackets were bonded on maxillary central incisors and the diastema closed allowing the spontaneous irruption of the maxillary laterals incisors. When acceptable levels of overbite and overjet were achieved and the habit was controlled, the orthodontic treatment was discontinued.Conclusion: To assure good results in managing pathological midline diastemas the diagnosis and treatment should be performed as early as possible.
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