space maintaner

1. SPACE MAINTAINERS
Dr.Badria Ali

2. Definition:

A fixed or removable appliance placed to
maintain space created by the premature loss
of a tooth or teeth.

5. why we do space maintainer?

The space of prematurely lost teeth usually
change in the following 6 months period,
sometimes a decrease in space may occur
within days or weeks which may cause loss of
arch length, resulting in crowding of the
permanent dentition, impaction of permanent
teeth, esthetic difficulties, malocclusion, and
other problems

6. IDEAL REQUIREMENTS

. 1. It should maintain the entire mesio-distal
space created by a lost tooth.
2. It must restore the function as far as
possible & prevent over-eruption of opposing
teeth.
3. It should be simple in construction.
4. It should be strong enough to withstand the
functional forces
5. It should not exert excessive stress on
adjoining teeth...

7. IDEAL REQUIREMENTS

6. It must permit maintenance of oral hygiene.
7. It should not come in the way of other
functions

8. Indications of space
maintainer:
1. If the space shows signs of closing.
2. If the use of space maintainer will make the
future orthodontic less complicated. .
3. When the space should be maintained for
two year or more.
4. To avoid supra eruption of opposing tooth.
5. To improve the masticatory system and
restore dental health.

9. contraindications of space
maintainer:

1. if the radiograph shows that tooth will erupt
soon.
2-. When the space left is greater than the
needed for the permanent as indicated from
radiographically.
3- If the space shows no signs of closing.
5. When the tooth is absent.

10. FACTORS INFLUNCE PLANNING
FOR SPACE MAINTAINER

1- Time lapse since lost :
is best to insert an appliance as soon as
possible
after the extraction.
2- Dental age of patient

11. 
:
3- Amount of bone covering the unerupted
tooth
if there is bone covering the crowns, it can be
readily predicted that eruption will not occur for
many months, a space-maintaining appliance
is indicated. tooth.

12. 
4- Sequence of eruption of teeth:
the dentist should observe the relationship of
developing & erupting teeth adjacent to the
space created by the untimely loss of a tooth

13. 
6) Delayed eruption of the permanent
tooth-
in case of impacted permanent tooth,it is
necessary to extract the primary
tooth,construct a space maintainer & allow the
permanent tooth to erupt at its normal
position.
7) Congenital absence of the permanent
tooth-

14. CLASSIFICATION OF SPACE
MAINTAINER

The classification of the space maintainers
According to Hitchcock:-
―Removable or fixed or semi-fixed.
―With bands or without bands.
―Functional or non-functional. ―Active or
passive. ―Certain combinations of the above.

15. CLASSIFICATION OF SPACE
MAINTAINER

3) Acc. To Hinrichsen
- Fixed space maintainers

- CLASS I :
(a) Non-functional types-
i. Bar type.
ii. Loop type.
(b) Functional types-
i. Pontic type.
ii. Lingual arch type.
CLASS II Cantilever type (distal shoe,band &
loop.) Removable space maintainers- Acrylic
partial dentures

16. 
2) According to Raymond C.Thurow:
―Removable
―Complete arch
― Lingual arch
― extra-oral anchorage
―Individual tooth

17. COMMONLY USED SPACE
MAINTAINERS

1- BAND & LOOP
2-CROWN & LOOP
3-LINGUAL ARCH HOLDING DEVICE
4- NANCE’S PALATAL HOLDING DEVICE
5--TRANS PALTAL
6-DISTAL SHOE
7-REMOVABLE SPACE MAINTAINER

18. BAND & LOOP SPACE
MAINTAINER

1-Most commonly used
2-Unilateral fixed appliance,nonfunctional,
passive pace maintainer
3- MAXILLARY or MANDIBULAR •

4-Can be bilateral if permanent teeth are not
present
4-Single tooth span

19. INDICATIONS

• Premature loss of any primary first molar in
the primary dentition or the primary maxillary
first molar in the transitional dentition.
• Premature loss of a primary second molar as
the permanent molar is erupting clinically

20. CONTRAINDICATION

• An occlusion that is extremely crowded or
already exhibits marked space loss.
• High dental caries activity.
• Replacement of primary anterior teeth.
• Replacement of primary second molar in the
primary dentition without partial clinical
eruption of the permanent I molar
• Cases that need guidence of eruption

21. CROWN & LOOP

Stainless steel crown is used as an
abutment

Stronger than band and loop

Cementation failure or loss are less likely

Excellent choice if tooth needs a restoration

22. DISTAL SHOE APPLIANCE

--Used when second primary molar requires
extraction and first permanent molar has not
erupted

-Maintain space of primary 2nd molar that has
been lost

23. Contra indication

• If several teeth are missing (abutment to
support the cemented appliance may be
missing)
• Poor oral hygiene
• Certain medical conditions like Blood
dyscrasias, etc.


24. LINGUAL ARCH SPACE
MAINTAINERS

1-Bands on first permanent molars
2- Bilateral, fixed or semi-fixed, non- functional
passive arch appliance

• Holds molar position distally & incisor
segment anteriorly

25. NANCE PALATAL ARCH

1- Bands on first permanent molars
It’s a simple maxillary lingual arch but does not
contact anterior teeth
2-It has an acrylic button in the mid palate

26. Indications

• Bilateral loss of multiple primary teeth
• Also serves as habit breaking appliance
(tongue thrusting) –
• Disadvantages:
Soft tissue irritation

27. TRANS PALATAL ARCH
APPLIANCE

1-unilatral missing of the teeth Can be used
like a Nance.
2-Advantage Lack of acrylic button so less
tissue irritation and more cleansable
3- Disadvantage Lack of anterior stop =
possible tooth shift

28. Space maintainance in maxillary
primary dentition
Reson
Suggested
tretment
Missing tooth
No sequene
excption if incisor
is lost prior to
primary canine
No space
maintenane
required
Incisior
Decrease
posiibility of
mildline shit
Band and loop
space maintanre
Canine
Prevent losse of
arch dimmention
Band –crown Loop
space maintainer
I molar
Guid l permenet
molar into position
Distal shoe space
maintainer
ll molar

29. Space maintainance in mandublure
primary dentition
Reson
Suggested tretment
Missing tooth
Decerease possibility
of maintainer midline
shift
Band & loop space
maintaner
canine
Prevents loss of loop
space arch maintainer
dimmension
Band/crown
I molar
molar into position
Prevents loss in arch
dimension
Distal shoe space
maintinor
. II molar
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