Types of Space Maintainers in Pedodontics

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What type of space maintainer is the transpalatal bar space maintainer?

Bilateral

When is the distal shoe space maintainer indicated?

When there is premature loss of second deciduous molar before eruption of first permanent molar

What is the purpose of the acrylic button in a space maintainer?

To irritate the soft tissue

In which situation is a Nance appliance preferred over a transpalatal bar space maintainer?

Loss of primary molars bilaterally

What does a distal shoe space maintainer lack compared to other types?

Functionality

When is a transpalatal bar space maintainer usually used?

When one side of the arch is intact and several primary teeth are missing in the other side

Which type of appliance extends into the alveolus?

Distal shoe space maintainer

Why is a Nance appliance preferred when both primary molars have been lost bilaterally?

To prevent mesial tipping of permanent molars

What is the main concern when both the first and second deciduous molars are missing in the same quadrant?

Aesthetics, speech, and function

What type of space maintainer can be removed and inserted into the oral cavity by the patient?

Removable space maintainer

When is a removable distal shoe space maintainer used?

When fixed distal shoe cannot be placed due to many missing teeth

Which of the following is a contraindication for using a distal shoe?

Loss of primary incisors

What is the most common reason for early loss of lower primary incisors?

Excessive incisor liability

What is a disadvantage of a band and loop space maintainer?

The loop may slip from the position and impinge on gum tissue

Which type of space maintainer is indicated when there is bilateral loss of molars after the permanent incisors have erupted in the lower arch?

Passive lingual arch space maintainer

Why is poor oral hygiene a contraindication for using a distal shoe?

Lack of patient and parent cooperation

What condition predisposes a patient to subacute bacterial endocarditis?

General debilitation

How does a fixed space maintainer differ from a removable one?

It is designed to be cemented onto a tooth

Which factor is NOT a contraindication for using a distal shoe?

Premature loss of deciduous teeth

When is a passive lingual arch appliance used?

When there is bilateral loss of molars after permanent incisors have erupted in the lower arch

What does a Nance palatal arch space maintainer prevent?

Collapse of anterior segment

Why is the presence of medical conditions a concern when using a distal shoe?

Predisposition to subacute bacterial endocarditis

In what situation might two band and loop space maintainers be given instead of a passive lingual arch space maintainer?

In bilateral molar loss after permanent incisors eruption in the lower arch

What does a passive lingual arch appliance prevent?

Mesial movement of posterior teeth

What is the major consequence of early loss of maxillary primary incisors?

Delayed eruption timing of permanent successors

What is the most common cause of ectopic loss of primary mandibular canine?

Ectopic eruption of permanent lateral incisors

What may happen if there is unilateral loss of lower primary canine?

Midline shift towards the side of loss

Which appliance option involves using artificial primary teeth for aesthetic and functional purposes?

Removable appliance with acrylic partial denture

What is an indicator for early orthodontic treatment according to the text?

Early loss of maxillary primary canine

Which consequences are associated with bilateral loss of both lower primary canines?

Deepening of overbite and increase in overjet

What is a potential outcome of ectopic loss of maxillary primary canine?

Crowding and blockage of permanent canine

The distal shoe space maintainer is indicated when there is premature loss of second deciduous molar before eruption of first permanent ______

molar

The transpalatal bar space maintainer is usually indicated for maxillary teeth when one side of the arch is intact and several primary teeth are missing in the other ______

side

The Nance appliance is preferred when both primary molars have been lost bilaterally as both permanent molars tip mesially with the transpalatal ______

bar

The distal shoe space maintainer is unilateral, fixed, non-functional, and passive, and it is an intra-alveolar appliance where a portion extends into the ______

alveolus

The distal shoe space maintainer lacks functionality compared to other types of space maintainers as it is non-______

functional

The transpalatal bar space maintainer provides enough stability for space maintenance when there is rigid attachment to the intact ______

side

The distal shoe space maintainer is indicated when there is one tooth lost on one quadrant due to the limited strength of the ______

appliance

The distal shoe space maintainer is used when there is a premature loss of second deciduous molar before eruption of first permanent ______

molar

The transpalatal bar space maintainer is indicated when one side of the arch is intact and several primary teeth are missing in the other ______

side

The distal shoe space maintainer is indicated when there is bilateral loss of molars after the permanent incisors have erupted in the lower ______

arch

Band and loop space maintainer is a unilateral, fixed, nonfunctional, and passive space maintainer used when a single tooth is missing in the ______ segment

posterior

Passive lingual arch appliance is a bilateral, fixed, nonfunctional, and passive space maintainer used for the ______ arch

mandibular

Nance palatal arch space maintainer is a bilateral, fixed, passive, and nonfunctional space maintainer for the ______ arch

maxillary

A piece of 0.036-inch steel wire is used to prepare the loop in the ______ space maintainer

band and loop

The loop in the band and loop appliance rests on the ______ surface of the mesial abutment tooth

occlusal

Passive lingual arch appliance prevents the mesial movement of ______ teeth

posterior

Nance palatal arch space maintainer is indicated when there is bilateral missing deciduous molars in the upper ______

arch

In the Nance palatal arch space maintainer, the arched wire extends from the palatal surface of one molar band to the other, anteriorly it extends up to the ______ area

rugae

A removable space maintainer can be functional or nonfunctional and are bilateral most of the time, it can be inserted into the oral cavity by the ______

patient

The distal shoe space maintainer is used when fixed distal shoe cannot be placed due to many missing ______

teeth

When both the first and second deciduous molars are missing in the same quadrant, __________ is preferred

removable distal shoe

Contraindications of distal shoe include inadequate abutments due to multiple loss of teeth, poor oral hygiene, missing permanent first molar, lack of patient and parent cooperation, and presence of medical conditions such as blood dyscrasias, congenital cardiac defect predisposing to subacute bacterial endocarditis, history of rheumatic fever, diabetes, general debilitation, premature loss of deciduous teeth, and loss of primary __________

incisors

The main concern with the loss of mandibular primary incisors is based on esthetic, speech, and __________

function

Early loss of lower primary incisors is generally due to ectopic eruption of permanent incisors in reflecting excessive incisor __________

liability

The distal shoe space maintainer is indicated when there is bilateral loss of molars after the permanent incisors have erupted in the lower arch, and it lacks the __________

acrylic button

A Nance appliance is preferred when both primary molars have been lost bilaterally to prevent __________

ectopic eruption

Poor oral hygiene is a contraindication for using a distal shoe due to inadequate __________

abutments

The presence of medical conditions is a concern when using a distal shoe to prevent complications such as subacute bacterial endocarditis in patients with congenital cardiac defects and a history of __________

rheumatic fever

The major consequence of early loss of maxillary primary incisors includes esthetic, speech, and __________ concerns

functional

Premature loss of deciduous teeth can lead to issues such as poor esthetics, speech problems, and __________ of the dental arch

collapse

Premature loss of primary canine, especially mandibular, is a significant indicator of a tooth size arch discrepancy. The consequence of early loss of lower primary canine includes shift in midline toward side of loss, lingual collapse of incisor segment, and possibly deepening of ______.

bite

If ectopic eruption involves bilateral loss of both lower primary canines, there is a pronounced lingual inclination and distal drifting of permanent incisors, deepening of overbite, and increased ______.

overjet

Early loss of maxillary primary canine may result in crowding and blockage of permanent canine because it erupts too late in normal transition. This is an indicator of early orthodontic treatment with an understanding that the child is a definite candidate for comprehensive ______ intervention.

orthodontic

If one primary canine is lost during incisor eruption, it may be desirable to extract the contralateral primary canine to maintain symmetry. Crowding problems requiring such intervention strongly indicate a significant arch length deficiency that will become grossly evident during permanent canine and ______ eruption.

premolar

A lingual holding arch may be used with spur attachments to control incisor positioning and prevent encroachment on permanent canine eruption positions when primary canines are lost ______.

prematurely

An anterior appliance incorporating artificial primary teeth may be considered to satisfy aesthetic and functional needs. Acrylic partial denture has been successful in replacement of single and multiple maxillary primary ______.

incisors

A fixed option may be considered using primary incisors denture teeth secured from a rigid stainless steel wire. This may be extended to bands or stainless steel crowns on the primary molars, a so-called 'hollywood' ______.

bridge

The ectopic loss of maxillary primary canine occurs less frequently than does mandibular loss. When it occurs, ectopic loss of maxillary primary canine typically reflects a very distal eruptive displacement of permanent lateral incisors and not necessarily a significant tooth mass problem. Resultant crowding and blockage of permanent canine may occur because it erupts too late in normal ______.

transition

If bilateral loss of both lower primary canines occurs, pronounced lingual inclination and distal drifting of permanent incisors, deepening of overbite, and increased overjet may be observed as ______ consequences.

dental

Early loss of maxillary primary canine is an indicator of early orthodontic treatment. It may result in crowding and blockage of permanent canine due to late eruption, emphasizing the need for comprehensive orthodontic ______.

intervention

Study Notes

Space Maintainers

  • A transpalatal bar space maintainer is a type of space maintainer.
  • A distal shoe space maintainer is indicated when there is premature loss of second deciduous molar before eruption of first permanent molar.

Indications and Contraindications

  • A distal shoe space maintainer is used when there is one tooth lost on one quadrant due to the limited strength of the anchor tooth.
  • A transpalatal bar space maintainer is indicated when one side of the arch is intact and several primary teeth are missing in the other side.
  • A Nance appliance is preferred when both primary molars have been lost bilaterally as both permanent molars tip mesially with the transpalatal arch.
  • A distal shoe space maintainer lacks functionality compared to other types of space maintainers as it is non-functional.
  • Poor oral hygiene is a contraindication for using a distal shoe due to inadequate oral hygiene.
  • The presence of medical conditions is a concern when using a distal shoe to prevent complications such as subacute bacterial endocarditis.

Types of Space Maintainers

  • A band and loop space maintainer is a unilateral, fixed, non-functional, and passive space maintainer used when a single tooth is missing in the posterior segment.
  • A passive lingual arch appliance is a bilateral, fixed, non-functional, and passive space maintainer used for the lower arch.
  • A Nance palatal arch space maintainer is a bilateral, fixed, passive, and non-functional space maintainer for the upper arch.

Concerns and Consequences

  • The main concern with the loss of mandibular primary incisors is based on esthetic, speech, and functional concerns.
  • Early loss of lower primary incisors is generally due to ectopic eruption of permanent incisors in reflecting excessive incisor crowding.
  • The major consequence of early loss of maxillary primary incisors includes esthetic, speech, and functional concerns.
  • Premature loss of deciduous teeth can lead to issues such as poor esthetics, speech problems, and narrowing of the dental arch.
  • The consequence of early loss of lower primary canine includes shift in midline toward side of loss, lingual collapse of incisor segment, and possibly deepening of overbite.

Treatment Options

  • A lingual holding arch may be used with spur attachments to control incisor positioning and prevent encroachment on permanent canine eruption positions when primary canines are lost early.
  • An anterior appliance incorporating artificial primary teeth may be considered to satisfy aesthetic and functional needs.
  • Acrylic partial denture has been successful in replacement of single and multiple maxillary primary teeth.

Learn about the different types of space maintainers in pedodontics, including removable space maintainers like acrylic partial dentures and complete dentures. These devices can help prevent dental issues caused by premature tooth loss in children.

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