A 10 year old male patient complains of spacing between his upper front teeth. On clinical examination, a midline diastema is seen. It is noted that the patient is in the mixed dentition period. Which of the following is an appropriate treatment protocol for this patient?
Around the age of 8 years, a midline diastema is commonly seen in the upper arch, which is usually misinterpreted by the parents as a malocclusion. Crowns of canines in young jaws impinge on developing lateral incisor roots, thus driving the roots medially and causing the crowns to flare laterally. The roots of the central incisors are also forced together thus causing a maxillary midline diastema. The period from the eruption of lateral incisor to canine is termed as the Ugly Duckling stage. It is an unaesthetic metamorphosis, which eventually leads to an aesthetic result. With eruption of canines, the impingement from the roots shifts incisally thus driving the incisor crowns medially, resulting in closure of the diastema.
Textbook of Orthodontics, Gurkeerat Singh, 2nd ed  Page 40-41
Frenectomy followed by orthodontic space closure
No intervention, spontaneous resolution
Fixed orthodontic therapy
Removable appliance to close the midline diastema