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Space maintainers

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Space maintainers Space maintainers Document Transcript

    • SPACE MAINTAINERSVESTA ENID LYDIA- R IV BDSPEDODONTICS SEMINARSYNOPSISINTRODUCTIONSPACE MAINTENANCECHANGES FOLLOWING PREMATURE LOSS OF TEETHSPACE CLOSURESPACE ANALYSISSPACE MAINTAINERSTREATMENT PLANNING FOR SPACE MAINTAINERSCLASSSIFICATION OF SPACE MAINTAINERSBAND & LOOP SPACE MAINTAINERCROWN & LOOP SPACE MAINTAINERLINGUAL ARCH SPACE MAINTAINERNANCE PALATAL ARCHTRANS PALATAL ARCH APPLIANCEDISTAL SHOE APPLIANCEREMOVABLE SPACE MAINTAINERSSPACE MAINTENANCE IN DECIDIOUS DENTITIONSPACE MAINTENANCE IN PERMANENT DENTITIONCONCLUSIONREFERENCE
    INTRODUCTION-<br />SPACE MANAGEMENT<br />CHANGES FOLLOWING PREMATURE LOSS OF TEETH<br />ETIOLOGY OF SPACE CLOSURE/CONTRIBUTING FACTORS<br />
    • Inclination of the long axis of molar
    • Path of least resistance
    • Influence of buccal musculature
    • Effect of the position of center of rotation of mandible
    PLANNING FOR SPACE MAINTAINANCE-FACTORS INVOLVED ARE<br />
    • Time lapse since lost
    • Dental age of patient
    • Amount of bone covering the unerupted tooth
    • Sequence of eruption of teeth
    • Delayed eruption of permanent teeth
    • Congenital absence of permanent teeth
    • Presence of oral habits
    • Existing malocclusion
    SPACE ANALYSIS<br />Commonly used mixed dentition analyses are<br />
    • Hays & nance analysis
    • Moyers analysis
    • Tanaka johnston analysis
    SPACE MAINTAINER<br />TREATMENT PLANNING FOR SPACE MAINTAINER<br />
    • PROPER EXAMINATION
    • COLLECTION OF DIAGNOSTIC DATA
    • ANALYSIS OF TOOTH DEVELOPMENT STAGE
    • ANALYSIS OF TOOTH SIZE
    • ANALYSIS OF SPACE AVAILABLE
    • PREDICTION OF GROWTH & FUTURE OCCLUSAL RELATIONSHIPS
    CLASSIFICATION OF SPACE MAINTAINERS<br />ACCORDING TO HINRICHSEN (1962)<br />1.FIXED <br />Class I a.Non-functional types<br />
    • Bar type
    • Loop type
    b.Functional types<br />
    • Pontic type
    • Lingual arch type
    Class Ii<br />Cantilever type<br />
    • Distal shoe type
    • Band and looptype
    2.REMOVABLE<br />a.Non-functional types<br />b.functional types<br />COMMONLY USED SPACE MAINTAINERS<br />
    • BAND & LOOP
    • CROWN & LOOP
    • LINGUAL ARCH HOLDING DEVICE
    • NANCE’S PALATAL HOLDING DEVICE
    • TRANS PALTAL ARCH
    • DISTAL SHOE
    • REMOVABLE SPACE MAINTAINER
    BAND & LOOP SPACE MAINTAINER<br />Most commonly used<br />Unilateral fixed appliance<br />Used in posterior segments<br />CROWN & LOOP SPACE MAINTAINER<br />Stainless steel crown is used as an abutment<br />Stronger than band and loop<br />Cementation failure or loss less likely<br />Excellent choice if tooth needs a restoration<br />LINGUAL ARCH SPACE MAINTAINERS<br />MANDIBULAR ONLY<br />
    • Bands on first permanent molars
    • Mandibular incisors often erupt lingually and are pushed forward by the tongue
    • LLHA should not be placed with primary incisors
    NANCE PALATAL ARCH<br />MAXILLARY ONLY<br />Bands on first permanent molars <br />It’s a simple maxillary lingual arch but does not contact anterior teeth<br />It has an acrylic button in the mid palate<br />TRANS PALATAL ARCH APPLIANCE<br />Can be used like a Nance.<br />Advantage<br />Lack of acrylic button so less tissue irritation and more cleansible<br />Disadvantage<br />Lack of anterior stop = possible tooth shift <br />DISTAL SHOE APPLIANCE<br />MAXILLARY or MANDIBULAR<br />Used when second primary molar requires extraction and first permanent molar has not erupted<br /> <br />DISTAL SHOE SPACE MAINTAINER (contd)<br />Should be evaluated with radiograph prior to cementation<br />Length<br />Position<br />Will be replaced with another space maintainer when permanent teeth erupt.<br />REMOVABLE SPACE MAINTAINERS<br />a.Non-functional types<br />b.Functional types<br />CLASSIFICATION OF REMOVABLE SPACE MAINTAINERS<br />REMOVABLE SPACE MAINTAINERS<br />It is like a removable partial denture<br />Not only Mesiodisatal space but also the vertical space is maintained<br />Mastigatory Function is restored in functional type<br />Esthetics & speech improvement is seen<br />SPACE MAINTENANCE IN MAXILLARY PRIMARY DENTITION<br />MISSING TOOTHSUGGESTED TREATMENTREASONIncisorNo space maintenance requiredNo consequence.exception if incisors are lost prior to primary canine eruptioncanineBand& loop space maintainerDecrease possibility of midline shiftI molarBand /crown & loop space maintainerPrevents loss of arch dimmensionII molarDistal shoe space maintainerGuides I premolar into proper positionPrevents loss in arch dimension<br />SPACE MAINTENANCE IN MANDIBULAR PRIMARY DENTITION<br />MISSING PRIMARY TOOTHSUGGESTED TREATMENTREASONcanineBand & loop space maintainerDecreases possibility of midline shiftI molarBand/crown loop space maintainerPrevents loss of arch dimmensionII molarDistal shoe space maintainerGuides I permanent molar into positionPrevents loss in arch dimmension<br />SPACE MAINTENANCE IN MIXED DENTITION –MAXILLARY<br />
    • MISSING PRIMARY TOOTHSUGGESTED TREATMENTREASONLateral incisorExtract antimereDecrease possibility of midline shiftcanineExtract antimereDecrease possibility of midline shiftI molarPrior to eruption of permanent lateral incisors removable space maintainersAfter eruption of permanent lateral incisors extract antimereGuides permanent lateral incisors into proper position and Prevents midline shiftII molar nance appliancePrevents loss in arch diameter
    SPACE MAINTENANCE IN MIXED DENTITION – MANDIBLE<br />MISSING TOOTHSUGGESTED TREATMENTREASONLateral incisorExtract antimereDecreases possibility of midline shift CaninePrior to eruption of permanent lateral incisor removable space maintainerAfter eruption of permanent incisors lingual arch space maintainer1.Requires only minor adjustment to afford normal positioning of permanent incisors2.decreases possibility of midline shift1.Decreases the possibility of midline shift2.prevents lingual tipping of permanent lateral incisorsI molarPrior to eruption of permanent lateral incisor r band/crown space maintainerAfter eruption of permanent incisors lingual arch space maintainer1.prevents loss in arch dimension2.does not interfere with eruption of permanent incisors1.prevents loss in arch dimension2.prevents distolateral repositioning of deciduous canine II molarPrior to eruption of permanent lateral incisor r band/crown space maintainerAfter eruption of permanent incisors lingual arch space maintainer1.prevents loss in arch dimension2.does not interfere with eruption of permanent incisors1.Prevents mesial tipping of permanent I molar2.prevents loss in arch dimension<br />CONCLUSION<br /> It has been stressed that importance of healthy, properly aligned deciduous teeth lays a foundation for the future dental health of the child, and preservation of primary teeth incluates the habit of preventing of dental diseases such as malocclusion at an early age…….<br />So it is been said that <br />PREVENTION IS BETTER THAN CURE…..<br />Hence extra care should be given for maintaining deciduous dentition…..<br />REFERENCES<br />MY SINCIERE THANKS TO<br />DR.XAVIER.MDS<br />DR.SARAVANAN.MDS<br />DR.SANGEETHA.BDS<br />DEPARTMENT OF PEDODONTICS<br />THANK ‘U’ HAVE A GREAT DAY….<br />