This document provides information about a lingual holding arch space maintainer. It describes the appliance as a bilateral, non-functional, passive mandibular arch appliance used to control anterior-posterior tooth movement and arch perimeter distortion. The key components are a round wire soldered to bands, most commonly on the permanent first molars. Advantages include modifications are possible and it can regain space, while disadvantages are difficult construction and potential for distortion. Fabrication involves adapting bands to the most posterior remaining tooth and soldering a pre-fabricated or custom made wire. The wire should contact the incisor cingulum and rest on the molar. Modifications and patient instructions are also outlined.

1. Lingual Holding Arch
Space Maintainer
• Presented by:
Jigyasha Timsina

2. Contents
• Introduction
• Indication and contraindication
• Advantages and disadvantages
• Fabrication
• Modification
• Patient Instruction

3. • Space maintaining appliance
• Bilateral ,Non functional ,Passive
mandibular arch appliance
•Fixed type of space maintainer
• Controls
1.Antero-posterior tooth movement
2.Arch perimeter distortion

4. CONTRAINDICATION
 Before the eruption
of mandibular incisors
INDICATIONS
 Bilateral loss of posterior
teeth
 Minor movement of
anterior teeth
 Maintenance of leeway
space
 Space regaining

5. Advantage
 Many modifications
are possible
Can also be used to
regain space
Disadvantage
Construction is difficult
Chances of distortion
of appliance by tongue
pressure

6. • Consists of :
1.round stainless steel or precious alloy
wire (0.32 to 0.40 inches in diameter)
2.molar bands -most commonly on
permanent first molar rarely second
deciduous molar

7. •
 Wire soldered or
welded to the band

8. Fabrication
 Bands are adapted to the most posterior
tooth remaining on the arch
A pick up alginate impression is taken.
 pre fabricated wire placed or soldered to
the band or can be custom made in lab

9. • 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

10.  Wire should have 3-4 mm
contact with the band to
provide long solder joint
 Konstantinos et al suggested
giving 2 omega bands in
canine region.
 Original design consisted of 2
inch adjustment loops so as
to allow for adjustment of
length

11. • Passivation
achieved by heating the wire to dull
brownish appearance

12. MODIFICATIONS
• Auxiliary springs incorporated to bring
about minor individual tooth movement
• Looped lingual archwire
• Ellis loop lingual archwires

13. Instruction to the patients
• Brush teeth at least 2 times daily.
• Use a water pick or floss to remove food
caught underneath the appliance.
• Contact if bands come loose or anything
breaks or wire gets bent.
• Warm salt water rinses for sores.
• 'Rescue' wax for bands until cheeks get
used to new appliance

14. References
• Textbook of Pediatric Dentistry
-Nikhil Marwah
• Text book of Pedodontics
-Shova Tandon
• Internet sources