SPACE MAINTAINERS

Space maintainer is a device used to maintain the space created by the loss of a deciduous tooth.

A space maintainer should fulfil the following requirements: –

1. It should maintain the entire mesio-distal space created by lost tooth
2. It must restore the function as far as possible & prevent over eruption of opposing teeth
3. It should be simple in construction.
4. It should be strong enough to withstand the functional forces.
5. It should not exert excessive stress on adjoining teeth
6. It must permit maintenance of oral hygiene.
7. It must not restrict normal growth & development and natural adjustments that take place during the transition from deciduous to permanent dentition.
8. The space maintainer should not come in the way of other functions,

TYPES OF SPACE MAINTAINERS:-

1. REMOVABLE SPACE MAINTAINERS
2. FIXED SPACE MAINTAINERS

REMOVABLE SPACE MAINTAINERS

They are space maintainers that can be removed & inserted into the oral cavity by the patient. Removable space maintainers can be classified as functional & non-functional space maintainers.

ADVANTAGES OF REMOVABLE SPACE MAINTAINERS: –

1.They are easy to clean & permit maintenance of proper oral hygiene.

2. They maintain or restore the vertical dimension.

3.They can be worn part time allowing circulation of the blood to soft tissues.

4. They serve other important functions like mastication, esthetics& phonetics.

5.Dental checkup for caries detection can be undertaken easily.

6.Room can be made for permanent teeth to erupt without changing the appliance.

7. They stimulate eruption of permanent teeth.

8.Band construction is not necessary.

9. They help in preventing development of tongue thrust habit into the extraction space.

DISADVANTAGES OF REMOVABLE SPACE MAINTAINERS: –

1.They may be lost or broken by the patient.

2.Unco operative patients may not wear the appliance.

3.Lateral jaw growth may be restricted, if clasps are in corporated.

4.They may cause irritation of the underlying soft tissues.

INDICATIONS OF REMOVABLE SPACE MAINTAINERS: –

1.If the permanent teeth have not fully erupted it may be difficult to adapt bands. Thus, it is advisable to use removable space maintainers.

2.Multiple losses of deciduous teeth that may require functional replacement in the form of either partial or complete dentures.

3.In case the radiograph reveals that the un erupted permanent teeth have five months’ time, a removable space maintainer can be given.

CONTRAINDICATIONS OF REMOVABLE SPACE MAINTAINERS:-

1.Lack of patient cooperation.

2.in patients who are allergic to acrylic materials.

3. Epileptic patients who have uncontrolled seizures.

SOME COMMONLY USED REMOVABLE SPACE MAINTAINERS-

ACRYLIC PARTIAL DENTURES

FULL OR COMPLETE DENTURES

REMOVABLE DISTAL SHOE SPACE MAINTAINER

FIXED SPACE MAINTAINERS

Space maintainers that are fixed or fitted on the teeth are called fixed maintainers.

ADVANTAGES OF FIXED SPACE MAINTAINERS

1.Bands and crowns are used which require minimum or no tooth preparation.

2. They do not interfere with passive eruption of abutment teeth.
3. Jaw growth is not hampered.
4. The permanent teeth are free to erupt into the oral cavity.
5. They can be used in un cooperative patients.

6.Masticatory function is restored if pontics are placed.

DISADVATAGES OF FIXED SPACE MAINTAINERS

1.They may result in decalcification of tooth material under the bands,

2.Supra eruption of opposing teeth can take place if pontics are not used.

3.If pontics are used it can interfere with vertical eruption of the abutment tooth and may prevent eruption of replacing permanent teeth if the patient fails to report.

EXAMPLES OF FIXED SPACE MAINTAINERS

BAND AND LOOP SPACE MAINTAINER: – Band and loop space maintainers are one of the most common space controlling appliances used in dental practice. The tooth distal to the extraction space is banded and a loop of thick stainless steel wire is soldered to it with its mesial to the extraction space. It is a unilateral fixed appliance indicated for space maintenance in the posterior segments when a single tooth is lost.

CROWN AND LOOP APPLIANCE: – Crown and loop appliances are similar to band and loop space maintainers in all respects except that a stainless steel crown is used for the abutment tooth.

LINGUAL ARCH SPACE MAINTAINER:- The lingual arch is the most effective appliance for space maintence in the lower arch.

PALATAL ARCH APPLIANCES:-They are designed to prevent mesial migration of maxillary molars.The nance holding arch is amaxillary lingual arch that doesnot contact the anterior teeth,but approximates the anterior plate.

TRANPALATAL ARCH:- More recently,transpalatal arch has been recommended for stabilizing the maxillary first permanent molars when primary molars require extraction.

DISTAL SHOE SPACE MIAINTAINER:-Also known as intra alveolar appliances.The distal surface of the s econd primary molar guides the unerupted first permanent molar.

ESTHETIC ANTERIOR SPACE MAINTAINERS:-The space maintainer consists of a plastic tooth fixed onto a lingual arch that in turn, is attached to molar bands.

Band and loop space maintainer

Crown and loop space maintainer and band & loop space maintainer

Nance holding arch and lingual arch space maintainer