Space maintainers

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Space maintainers

  1. 1. SYNOPSIS  INTRODUCTION  SPACE MAINTENANCE  CHANGES FOLLOWINGPREMATURE LOSS OF TEETH  SPACE CLOSURE  SPACE ANALYSIS  SPACE MAINTAINERS  TREATMENT PLANNING FOR SPACE MAINTAINERS  CLASSSIFICATION OF SPACE MAINTAINERS  BAND & LOOP SPACE MAINTAINER  CROWN & LOOP SPACE MAINTAINER  LINGUAL ARCH SPACE MAINTAINER  NANCE PALATAL ARCH  TRANS PALATAL ARCH APPLIANCE  DISTAL SHOE APPLIANCE  REMOVABLE SPACE MAINTAINERS  SPACE MAINTENANCE IN DECIDIOUS DENTITION  SPACE MAINTENANCE IN PERMANENT DENTITION  CONCLUSION  REFERENCE SPACE MAINTAINERS VESTA ENIDLYDIA-R IV BDS PEDODONTICS SEMINAR
  2. 2. 1 INTRODUCTION- SPACE MANAGEMENT CHANGES FOLLOWING PREMATURE LOSS OF TEETH
  3. 3. 2 ETIOLOGY OF SPACE CLOSURE/CONTRIBUTING FACTORS  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  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
  4. 4. 3  Congenital absence of permanent teeth  Presence of oral habits  Existing malocclusion SPACE ANALYSIS Commonly used mixed dentition analyses are  Hays & nance analysis  Moyers analysis  Tanaka johnston analysis SPACE MAINTAINER TREATMENT PLANNING FOR SPACE MAINTAINER PROPER EXAMINATION COLLECTION OF DIAGNOSTIC DATA
  5. 5. 4 ANALYSIS OF TOOTH DEVELOPMENT STAGE ANALYSIS OF TOOTH SIZE ANALYSIS OF SPACE AVAILABLE PREDICTION OF GROWTH & FUTURE OCCLUSAL RELATIONSHIPS CLASSIFICATION OF SPACE MAINTAINERS ACCORDING TO HINRICHSEN (1962) 1.FIXED a.Non-functional types Bar type Loop type b.Functional types Pontic type Lingual arch type
  6. 6. 5 Cantilever type Distal shoe type Band and looptype 2.REMOVABLE a.Non-functional types b.functional types COMMONLY USED SPACE MAINTAINERS  BAND & LOOP  CROWN & LOOP  LINGUAL ARCH HOLDING DEVICE
  7. 7. 6  NANCE’S PALATALHOLDING DEVICE  TRANS PALTALARCH  DISTAL SHOE  REMOVABLE SPACE MAINTAINER BAND & LOOP SPACE MAINTAINER Most commonly used Unilateral fixed appliance Used in posterior segments CROWN & LOOP SPACE MAINTAINER Stainless steel crown is used as an abutment
  8. 8. 7 Stronger than band and loop Cementation failure or loss less likely Excellent choice if tooth needs a restoration LINGUAL ARCH SPACE MAINTAINERS MANDIBULAR ONLY  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
  9. 9. 8 NANCE PALATAL ARCH MAXILLARY ONLY Bands on first permanent molars It’s a simple maxillary lingual arch but does not contact anterior teeth It has an acrylic button in the mid palate TRANS PALATAL ARCH APPLIANCE Can be used like a Nance. Advantage Lack of acrylic button so less tissue irritation and more cleansible Disadvantage Lack of anterior stop = possible tooth shift
  10. 10. 9 DISTAL SHOE APPLIANCE MAXILLARY or MANDIBULAR Used when second primary molar requires extraction and first permanent molar has not erupted DISTAL SHOE SPACE MAINTAINER (contd)
  11. 11. 10 Should be evaluated with radiograph prior to cementation – Length – Position Will be replaced with another space maintainer when permanent teeth erupt. REMOVABLE SPACE MAINTAINERS
  12. 12. 11 a.Non-functional types b.Functional types CLASSIFICATION OF REMOVABLE SPACE MAINTAINERS REMOVABLE SPACE MAINTAINERS It is like a removable partial denture Not only Mesiodisatal space but also the vertical space is maintained Mastigatory Function is restored in functional type Esthetics & speech improvement is seen
  13. 13. 12 SPACE MAINTENANCE IN MAXILLARY PRIMARY DENTITION MISSING TOOTH SUGGESTED TREATMENT REASON Incisor No space maintenance required No consequence.exception if incisors are lost prior to primary canine eruption canine Band& loop space maintainer Decrease possibility of midline shift I molar Band /crown & loop space maintainer Prevents loss of arch dimmension II molar Distal shoe space maintainer Guides I premolar into proper position Prevents loss in arch dimension
  14. 14. 13 SPACE MAINTENANCE IN MANDIBULAR PRIMARY DENTITION MISSING PRIMARY TOOTH SUGGESTED TREATMENT REASON canine Band & loop space maintainer Decreases possibility of midline shift I molar Band/crown loop space maintainer Prevents loss of arch dimmension II molar Distal shoe space maintainer Guides I permanent molar into position Prevents loss
  15. 15. 14 in arch dimmension SPACE MAINTENANCE IN MIXED DENTITION –MAXILLARY MISSING PRIMARY TOOTH SUGGESTED TREATMENT REASON Lateral incisor Extract antimere Decrease possibility of midline shift canine Extract antimere Decrease possibility of midline shift I molar  Prior to eruption of permanent lateral incisors removable space maintainers  After eruption of permanent lateral incisors extract antimere  Guides permanent lateral incisors into proper position and  Prevents midline shift
  16. 16. 15 II molar nance appliance Prevents loss in arch diameter SPACE MAINTENANCE IN MIXED DENTITION – MANDIBLE MISSING TOOTH SUGGESTED TREATMENT REASON Lateralincisor Extract antimere Decreases possibilityof midline shift Canine Priorto eruptionof permanentlateralincisor removablespacemaintainer After eruptionof permanent incisorslingualarchspace maintainer 1.Requiresonlyminor adjustment to afford normalpositioningof permanentincisors 2.decreases possibilityof midline shift 1.Decreasesthe possibility of midlineshift 2.preventslingualtippingof permanentlateralincisors I molar Priorto eruptionof permanentlateralincisorr band/crownspacemaintainer After eruptionof permanent incisorslingualarchspace maintainer 1.preventsloss in arch dimension 2.does not interferewith eruption of permanentincisors 1.preventsloss in arch dimension 2.preventsdistolateral repositioningof deciduouscanine II molar Priorto eruptionof permanentlateralincisorr 1.preventsloss in arch dimension 2.does not interferewith eruption
  17. 17. 16 band/crownspacemaintainer After eruptionof permanent incisorslingualarchspace maintainer of permanentincisors 1.Preventsmesialtippingof permanentI molar 2.preventsloss in arch dimension CONCLUSION It has been stressed that importanceof healthy, properly aligned deciduous teeth lays a foundationfor the future dental health of the child, and preservationof primary teeth incluates the habit of preventing of dental diseases such as malocclusion at an early age……. So it is been said that PREVENTION IS BETTERTHAN CURE….. Hence extra care should be given for maintaining deciduous dentition….. REFERENCES MY SINCIERE THANKS TO DR.XAVIER.MDS DR.SARAVANAN.MDS
  18. 18. 17 DR.SANGEETHA.BDS DEPARTMENT OF PEDODONTICS THANK‘U’HAVEAGREATDAY….

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