Efficient diastema closure. Part 2: The incisal first technique (IFT) for larger diastema closure.

OBJECTIVE: This article presents the incisal first technique (IFT) as a systematic and conservative approach to restoring larger anterior diastemas using direct composite resin. It is the second part of a two-part series published in IJED; the first part being 'Efficient diastema closure, Part 1: The modified Mylar pull technique for small diastema closure.' The present article emphasizes precise incisal edge placement as the initial step in guiding tooth proportion, contact point positioning, and the emergence profile. CLINICAL CONSIDERATIONS: Conventional techniques for larger diastema closure may rely on wax-ups, mock-ups, or full-surface composite veneering, which can complicate workflow and compromise natural esthetics. The IFT simplifies the process by establishing the incisal edge and final tooth width from the outset, using this reference to guide proportion, contact point positioning, and the emergence profile. The technique builds composite sequentially-starting from the incisal edge and progressing palatally and buccally-while preserving gingival health and tooth anatomy. The modified Mylar pull technique (MMPT) is performed from both palatal and buccal directions to achieve seamless, void-free proximal contact and controlled line angle placement. The IFT allows clinicians to restore complex spaces conservatively, without altering the buccal surface too much or requiring additional preparatory and finishing steps. CONCLUSIONS: The IFT offers a conservative and predictable method that focuses on incisal edge positioning and maintaining biologic and optical parameters. It simplifies tooth proportion control and contact formation and enhances workflow efficiency while maintaining esthetic and biologic integrity. Anatomically correct, void-free larger diastema closure with highly predictable esthetic outcomes can be achieved with a simplified clinical execution while preserving tissue health and structural integrity.