Space Management in Pediatric Patients Part 2

Space Management in Pediatric Patients Part 2. By : Amira S. Badran Associate Professor Pediatric Dentistry & Dental Public Health Faculty of Dentistry, Ain Shams University.

Space maintainers. Space maintainer: 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..

Types of space maintainers. Unilateral fixed: Band & loop / Crown & loop Distal shoe Fiber reinforced Bilateral fixed Lower lingual holding arch Trans palatal arch Nance appliance Pedi partial Removable Different designs.

Lingual Arch space maintainer. 974s030. 537s006v01.

Lingual Arch space maintainer. Indications: 1.To preserve the space created by multiple loss of primary lower molars. 2. Preventive measure to maintain arch perimeter preventing both mesial drifting of molars and lingual collapse of lower anteriors . 3. Bilateral loss of primary molars after eruption of lower lateral incisors..

Lingual Arch space maintainer. Advantages: Arch holding space maintainer Can also be used to regain space.

Lingual Arch space maintainer. Dis advantages: 1. Difficult construction. 2. More chances of distortion of appliance by tongue pressure. 3. May cause unwanted movements..

Modification of Lingual Arch space maintainer. Hotz lingual arch With u shaped loops used for space regaining..

Nance Appliance (palatal arch space maintainer). 974s023.

Nance Appliance (palatal arch space maintainer). Indications: Bilateral premature loss of primary teeth..

Nance Appliance (palatal arch space maintainer). Advantages: Maintain arch stability. Disadvantages: Irritation to palatal tissues(lack of hygiene). Pressure on soft tissues. Can not be used in patients allergic to acrylic..

Transpalatal arch. Indications: When one side of arch is intact and several primary teeth are missing on the other side. Advantages: Can be used for expansion. Disadvantages: Both molars can tip together..

Distal shoe ( intralveolar space maintainer). 2rv3s026.

Distal shoe ( intralveolar space maintainer). Indications: When the second primary molar is extracted or lost before the eruption of the first permanent molar..

Distal shoe ( intralveolar space maintainer). Advantages: The only space maintainer that can be used if there is premature loss of primary second molar before eruption of permanent molars. Disadvantages: Can cause infection. Retention is not good. Difficult to construct. May permit tipping if not placed properly..

Glass Fiber-reinforced Composite Resin space maintainer.

Glass Fiber-reinforced Composite Resin space maintainer.

Glass Fiber-reinforced Composite Resin space maintainer.

Glass Fiber-reinforced Composite Resin space maintainer.

Glass Fiber-reinforced Composite Resin space maintainer.

Space maintenance in anterior region. When a primary anterior tooth is lost prematurely the drift of the adjacent teeth into the space created rarely occurs. Loss of function (biting, pronunciation and esthetics) is main concern. Esthetic functional space maintainer is thus fabricated to restore esthetics and maintain function ( e.g Pedi partial space maintainer)..

Space maintenance in anterior region. 913s017. 913s039.

Removable space maintainers. BitMap Image. 537s008.

Removable space maintainers. Indications: Esthetic factors are of importance. The abutment teeth can not support a fixed appliance. A cleft palate patient. Child has reached mental age of 4 years. Permanent teeth are not fully erupted for adaptation of bands. Multiple loss of primary teeth..

Removable space maintainers. Contraindications: Lack of patient parent cooperation. Child is younger than 4 years. If the patient is allergic to acrylic. Epileptic patients. Children with high caries activity..

Removable space maintainers. Advantages: Ease of fabrication. Easy to clean. Restore vertical dimension. Help in mastication. Alterations can be made without changing the appliance..

Removable space maintainers. Disadvantages: May be lost or broken. Can not be used in un cooperative children. May cause irritation and allergy to underlying tissues..