Space maintainers
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Transcript of Space maintainers
SPACE MAINTAINERS
SUBMITTED BYSUBINA NAZRIN
3rd BDSDEPARTMENT OF PEDIATRIC DENTISTRY
SPACE MAINTAINER
S
DEFINITION•This term was coined by JC Brauer in 1941.It is defined as the process of maintaining a space in a given arch previously occupied by a tooth or a group of teeth
•Boucher :it is a fixed or removable appliance designed to preserve the space created by the premature loss of a primary tooth or a group of teeth
Space maintainers are devices used to maintain or regain the space following the loss of deciduous tooth or teeth
Five milk teeth
Permanent(1,2,3,) Teeth are Erupted & Milk Teeth (D,E)
This is a case of decay in Milky Tooth
Witout treatment the milk tooth starts breaking
Removing the decayed tooth
Because of open space the first permanent molar will start tilting forward
6 Has Tilted Closing The Spacement For 5
The Second Premolar is trapped now
A space maintainer can be used to prevent such a situation
W hy is it necessary to use a space maintainer?
If a child loses a baby tooth early through decay or injury, the child's other teeth could shift and begin to fill the vacant space. When the child's permanent teeth emerge, there's not enough room for them. The result is crooked or crowded teeth and difficulties with chewing or speaking.
This is a ideal case where a space maintainer would have helped
The best space maintainer is a primary tooth
Causes…..•Premature loss of teeth• Interproximal caries•Ectopic eruption of 1st permanent molars
•Delayed eruption•Ankylosis of primary molars•Disproportionate tooth size,etc
INDICATIONS1. If the space shows signs of
closing.2. If the use of space maintainer
will make the future orthodontic less complicated.
3. If the need for treatment of malocclusion at a later date is not indicated.
INDICATIONS(contd….)4. When the space should
be maintained for two year or more.
5. To avoid supra eruption of opposing tooth.
6. To improve the masticatory system and restore dental health.
CONTRAINDICATIONS1. if the radiograph shows that the
succedant tooth will erupt soon.2. If the radiograph shows one third
of the root of is already calcified.3. When the space left is greater
than the needed for the permanent as indicated from radiographically.
4. If the space shows no signs of closing.
5. When the succedenous tooth is absent.
Requirements• It should maintain the entire space created by the tooth
• It must restore function
•Prevent supraeruption of opposing tooth
• It should be simple in construction
Contd……• It should be strong enough to withstand occlusal forces
•Should permit maintenance of oral hygiene
•Must not restrict the growth of jaws
• It should not exert undue forces of its own
CLASSIFICATION OF SPACE MAINTAINER
The classification of the space maintainers can be summarized in the following
According to function: FunctionalNon-functional
According to activity:ActivePassiveAccording to retention:FixedSemi fixedRemovable
Commonly used Space maintainers
BAND & LOOP CROWN & LOOP LINGUAL ARCH HOLDING DEVICE NANCE’S PALATAL HOLDING
DEVICE TRANS PALTAL DISTAL SHOE REMOVABLE SPACE MAINTAINER
BAND AND LOOP
Most commonly used
Unilateral fixed appliance Used in posterior segments
CROWN AND LOOP
CROWN AND LOOPStainless steel
crown is used as an abutment
Stronger than band and loop
Cementation failure or loss are less likely
Excellent choice if tooth needs a restoration
LINGUAL ARCH HOLDING DEVICE
DEVICE Bands on first
permanent molars
Anteriorly it rests at the cinguli of the Incisors
LINGUAL ARCH HOLDING DEVICE
Mandibular incisors often erupt lingually and are pushed forward by the tongue
LLHA should not be placed with primary incisors
NANCE PALATAL ARCH SPACE MAINTAINER
It’s a simple maxillary lingual arch but does not contact anterior teeth
Bands on first permanent molars
It has an acrylic button
in the mid palate
TRANSPALATAL ARCH
TRANSPALATAL ARCH Can be used like a Nance.
Advantage Lack of acrylic button so less tissue irritation and more cleansable
Disadvantage Lack of anterior stop = possible tooth shift
DISTAL SHOE SPACE MAINTAINER
Used when second primary molar requires extraction and first permanent molar has not erupted
Primary canine and first molar (c,d)
DISTAL SHOE SPACE MAINTAINER
Primary second molar (e),has
been extracted and permanent
first molar has not been erupted
Should be evaluated with radiograph prior to cementation
– Length – Position
Will be replaced with another space maintainer when permanent teeth erupt.
REMOVABLE SPACE MAINTAINERS
a.Non-functional types b.Functional types
It is like a removable partial denture Not only Mesiodistal space but also the vertical space is maintained. masticatory Function is restored in functional type Esthetics & speech improvement is seen
removable unilateral space maintainers
They are too small and present swallowing and choking dangers for children.
SPACE MAINTENANCE IN MAXILLARY PRIMARY DENTITION
REASON SUGGESTED TREATMENT
MISSING TOOTH
No consequence. Exception if incisors are lost prior to primary canine eruption
No space maintenance required
Incisor
Decrease possibility of midline shift
Band& loop space maintainer
canine
Prevents loss of arch dimension
Band /crown & loop space maintainer
I molar
Guides I premolar into proper position Prevents loss in arch dimension
Distal shoe space maintainer
II molar
SPACE MAINTENANCE IN MANDIBULAR PRIMARY DENTITION
REASON SUGGESTED TREATMENT
MISSING PRIMARY TOOTH
Decreases possibility of midline shift
Band & loop space maintainer
canine
Prevents loss of arch dimmension
Band/crown loop space maintainer
I molar
Guides I permanent molar into position Prevents loss in arch dimension
Distal shoe space maintainer
II molar
Our Objective….Our primary objective is to make a study model for better understanding of the use of Space maintainers.
We have 3 instances….The first one is the normal situation,where we have the deciduous teeth harbouring the permanent teeth
Our Objective….The 2nd one is when we have a
premature loss of Deciduous teethThe 3rd one shows the space
maintainer incorporated into the space
Thankyou