Lingual arch space maintainer

lingual arch space maintainer
indications
contraindications
modifications

1. Lingual Arch Space Maintainer Presented by : Rahaf Najjar

2. Defi nitio n: Fixed, passive, non functional space maintaining appliance. Bilateral mandibular appliance. Used to control: 1.Antero-posterior tooth movement 2.Arch perimeter distortion

3. Indications: Bilateral loss of single / multiple 1ry lower molars, after eruption of lower incisors. Minor movement of anterior teeth Maintenance of leeway space

4. C ontraindications: Before the eruption of permanent lower incisors.

5. Disadvantages Advantages doesn't prevent extrusion of opposing teeth. High chance of appliance distortion by tongue force. Can promote decay in pts with bad OH. Allow eruption of permeant without interference. Not easily displaced. Easy to maintain good OH. Can be modified and used as space regaining appliance. Patients comfort.

6. Parts of the Appliance: 2 bands in permeant 1 st molars/ rarely in 2 nd deciduous molars (E’s). Stainless steel wire. The wire is soldered to the bands.

7. Fabrication: Bands are adapted to the molars. A pick up alginate impression is taken. prefabricated wire placed or soldered to the band or can be custom made in lab

8. Wire should contact cingulum of mandibular incisors slightly above gingival papillae . Should lie on gingival third of primary molar Should rest at middle third of banded molar

9. Modifications: Auxiliary springs incorporated to bring about minor individual tooth movement Looped lingual arch

10. 3D ®  Lingual Arch: This appliance allows for a set-up of a more positive anchorage for a variety of treatment functions. The Lingual Arch plugs into the lingual tube and is available in eight sizes.

11. The Pedo Partial Appliance: F abricated with a lingual arch soldered to bands and pedo teeth in acrylic . Each tooth is reinforced to prevent breakage.

12. References: Paul S. Casamassimo DDS MS  . Pediatric Dentistry: Infancy through Adolescence, 5 th edition https ://www.rmortho.com/products/3d-lingual-arch /  Angus C. Cameron BDS. Handbook of Pediatric Dentistry, 4 th edition  Jeffrey A. Dean DDS MSD. McDonald and Avery Dentistry for the Child and Adolescent, 9th Edition