Clinical Technique: Removable Appliance Therapy for Space Maintenance Following Early Loss of Primary Molars
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Background: Premature loss of the second primary molar, prior to the eruption of the first permanent molar in the absence of the second primary molar, may lead to mesial movement and migration of the permanent molar before and during its eruption. The traditional appliance has been the distal shoe space maintainer, but fabrication and placement can be quite complicated. Clinical technique: The use of the removable appliance is described and advocated, although this treatment method was described over 20 years ago but has not gained widespread use. The purpose of this paper is to reintroduce the technique and present its clinical use allowing the permanent molar to erupt into proper position. Treatment: Acrylic removable appliances, these days with multi-coloured acrylics to make them attractive to children, are used. A minimum amount of wire clasps may be used for retention of the appliance. Ball clasps and 3/4 clasps are recommended and seldom are Adam’s clasps used. In most cases, the appliance is used as an interim treatment, however, if the appliance is to be present long term, its design will need to take into consideration canine movement and development. Follow-up: This should be at 3 month intervals with an emphasis on good oral hygiene and cleaning of the appliance.
Key wordsspace maintainer primary molars
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- Carroll CE, Jones JE. Pressure-appliance therapy following premature loss of primary molars. J Dent Child 1982;49:347–51.Google Scholar
- Hicks ER Treatment planning for the distal shoe space maintainer. Dent Clin N Amer 1973; 17: 135–50.Google Scholar
- Rapp R, Demiroz I: A new design for space maintainers replacing prematurely lost first primary molars. Pediatr Dent t 1983;5:131–4.Google Scholar