Use of space maintainers in children following early loss of deciduous teeth: A case series

Abstract

Early loss of deciduous teeth commonly occurs due to dental caries and trauma. When an extraction is planned it is possible to maintain the space following tooth removal utilizing an appropriate space maintainer. However, there is no strict guideline or evidence to support this practice. Furthermore, provision of prosthesis is both financially and technically demanding. Therefore, children often present with detrimental effects such as crowding, impaction, midline deviation, over eruption of opposing teeth and ultimately complain of functional and esthetic complications. A case series on the use of different types of space maintainers in a cohort of four patients in the age group of 7-12 years is presented. Case 01: Crown and loop on mandibular right first deciduous molar Case 02: Crown and loop on maxillary right first deciduous molar and an acrylic Removable partial denture for the mandibular deciduous molars.Case 03: Band and loop on left mandibular first permanent molar Case 04: Maxillary Trans palatal arch with Nance button Literature recommends review visits at least at 6-month intervals; however, this may vary depending on the caries risk of individual patient. Space maintainers can undergo de-cementation, become loosen with time, wear off, accumulate dental plaque and even cause soft tissue irritation. Therefore, replacement or repair may be required. Based on recent evidence authors suggest use of Crown and loop for unilateral loss of the said teeth unless the adjacent tooth has no dental caries or indication for placing a prosthetic crown. Such patients may benefit with Band and loop or Direct bonding technique. Bilateral tooth loss can be treated with Trans palatal arch, Lingual arch fixed prosthesis or a Removable acrylic denture.