Fixed and Removable Space maintainers in orthodontics

different types of space maintainers
Advantages and disadvantages of each maintainer

1. FIXED & REMOVABLE SPACE MAINTAINERS

2. FIXED SPACE MAINTAINERS : Band & loop space maintainer Crown & loop appliance Lingual arch space maintainer Palatal arch appliance Trans palatal arch appliance Distal shoe space maintainer Esthetics anterior space maintainer Band & bar type space maintainer Preformed bonded space maintainer 

3. BAND & LOOP SPACE MAINTAINER Advantages: Easy to construct Inexpensive Easily adjusted Allows eruption of permanent tooth Non invasive Painless Disadvantages: Not restore masticatory function Not prevent extrusion of opposing dentition Not allow normal distal movement of primary cuspids during eruption of permanent lateral incisor if placed for the early loss of mandibular first primary molar Most common space controlling appliances The tooth distal to the extraction space is banded and a loop of thick stainless steel wire is soldered to its mesial end touching the tooth mesial to the extraction space. It is a unilateral fixed appliance for space maintenance in posterior segment when a single tooth is lost.

4. CROWN & LOOP APPLIANCE Advantages: Stronger than band and loop Cementation failure loss are less likely Excellent choice if tooth needs a restoration Disadvantage: Difficult to fabricate than band and loop Similar to band and loop appliances except that a stainless steel crown is used for abutment tooth.

5. PALATAL ARCH APPLIALNCE Advantages: Prevent mesial migration of maxillary molars Disadvantages: Soft tissue irritation They prevent mesial migration of maxillary molars. The nance holding arch is maxillary lingual arch that does not contact the anterior teeth but approximates the anterior palate. It incorporates an acrylic button in the anterior region that contacts the palate tissue.

6. LINGUAL ARCH SPACE MAINTAINER Advantages: Maintain arch form Allow eruption of permanent teeth without interference Not easily displaced Easy to maintain good oral hygiene Can be modified and used as space regaining appliance Patients comfort Disadvantages: Doesn’t prevent extrusion of opposing teeth High chance of appliance distortion by tongue force Can promote decay in pts with bad oral hygiene Most effective appliance for space maintenance in lower arch. It prevents mesial drifting of molars and lingual collapse of anterior teeth

7. TRANSPALATAL ARCH APPLIANCE Advantages: Lack of acrylic button so less tissue irritation and more cleansable Disadvantages: Lack of anterior stop due to which possible tooth shift It consists of a thick stainless steel wire that spans on the palate connecting the first permanent molar of one side with other. It has been recommended for stabilizing the maxillary First permanent molar when the primary molar require extraction.

8. DISTAL SHOE SPACE MAINTAINER Advantages: Maintains second primary molar space. Disadvantages: Difficult to fabricate Also known as intra-alveolar appliance The distal surface of second primary molar guides the unerupted First permanent molar to erupt in normal position.

9. ESTHETIC ANTERIOR SPACE MAINTAINER Advantages: Reduce palatal coverage Provide an esthetic component Improve anterior fit due to modified ridge lap design Disadvantages: Poor oral hygiene maintenance Distortion and breakage by children

10. BAND & BAR TYPE SPACE MAINTAINER PREFORMED BONDED SPACE MAINTAINER  In this abutment teeth on either side of extraction space are banded connected to each other by a bar. This is a direct bonded space maintainer that consists of two bonded mesh pads that are bonded to the teeth on either side of the lost tooth.

11. REMOVABLE SPACE MAINTAINERS: Acrylic partial dentures Full or complete dentures Removable distal shoe space maintainer

12. ACRYLIC PARTIAL DENTURES It is used in patients who have gone multiple extractions It is readily adjusted to allow eruption of teeth Advantages: Easy to clean Restore masticatory function and esthetics Stimulate eruption of permanent teeth Help in preventing the development of tongue thrust habit into the extraction space Disadvantages: May be lost or broken by patient Lateral jaw growth may be restricted if claps are incorporated They may cause irritation to the underlying soft tissues

13. FULL OR COMPLETE DENTURES Advantages: Easy to clean Restore masticatory function and esthetics Guide permanent molar into their correct position Disadvantages: May be lost or broken by patient They may cause irritation to the underlying soft tissues It is use to restore primary teeth of Child may require extraction due to rampant caries.

14. REMOVABLE DISTAL SHOE SPACE MAINTAINER Advantages: Guide the first permanent molar into its position before its occlusal eruption Disadvantages: Multiple impression required Complicated appliance with limited strength and no functional strength It is an immediate acrylic partial denture with an acrylic distal shoe extension

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