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    Space Maintainer

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    neometal_86
    This document discusses space maintainers, which are devices used to maintain space following the loss of a primary tooth in order to guide the permanent tooth into the proper position. It describes the objectives, requirements, considerations, indications, contraindications, types of appliances including fixed and removable options, and provides examples of different space maintainer designs. The purpose of space maintainers is to preserve space, maintain dental arch integrity and function, and guide proper eruption of permanent teeth.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd

    Space Maintainer

    Uploaded by

    neometal_86
    1K views28 pages
    This document discusses space maintainers, which are devices used to maintain space following the loss of a primary tooth in order to guide the permanent tooth into the proper position. It describes the objectives, requirements, considerations, indications, contraindications, types of appliances including fixed and removable options, and provides examples of different space maintainer designs. The purpose of space maintainers is to preserve space, maintain dental arch integrity and function, and guide proper eruption of permanent teeth.

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    Space maintainer

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    © Attribution Non-Commercial (BY-NC)

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    This document discusses space maintainers, which are devices used to maintain space following the loss of a primary tooth in order to guide the permanent tooth into the proper position. It describes the objectives, requirements, considerations, indications, contraindications, types of appliances including fixed and removable options, and provides examples of different space maintainer designs. The purpose of space maintainers is to preserve space, maintain dental arch integrity and function, and guide proper eruption of permanent teeth.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    1K views28 pages

    Space Maintainer

    Uploaded by

    neometal_86
    This document discusses space maintainers, which are devices used to maintain space following the loss of a primary tooth in order to guide the permanent tooth into the proper position. It describes the objectives, requirements, considerations, indications, contraindications, types of appliances including fixed and removable options, and provides examples of different space maintainer designs. The purpose of space maintainers is to preserve space, maintain dental arch integrity and function, and guide proper eruption of permanent teeth.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 28

    m  

    Space management«
    By space maintainer«.
    a Device used to maintain or regain space following loss
    of primary tooth. So as to guide the permanent to
    erupt in the proper position in the arch

    a Objective:
    Preservation of space
    Integrity of dental arch
    Normal occlusal plane
    esthetic
    ajequirement:
     do not interfere with the replacing permanent
    tooth
     maintain the entire mesio-distal space
     simple construction
     restore function
     prevent over-eruption of opposing tooth
     do not exert excessive stress on adjoining tooth
     easily cleansable
     does not restrict normal growth & dev of dental
    arch
    a=eneral consideration;
     Time elapsed since loss
     Before 6 months after tooth loss
     Insert SM as soon as the tooth is removed
     Dental age of the patient
     Permanent will erupt when 3/4 of root is completed
     Amount of bone covering unerupted tooth
     Sequence of eruption
     Delayed eruption of permanent tooth
     Congenital absence of permanent tooth
     Presentation of problems to the parents
    Indication..
    „ Closure of space following premature loss
    „ If the space after premature loss of deciduous teeth
    shows signs of closing.
    „ If the need for treatment of malocclusion at a later
    stage is not indicated.
    „ When the space for a permanent tooth should be
    maintained for two years or longer.
    „ To avoid supra ² eruption of a tooth from the opposing
    arch.
    „ To improve the physiology of a child·s masticatory
    system and restore dental health optimally.
    Contraindication..
    „ If the radiograph of extraction region shows that
    the succedaneous tooth will erupt soon
    „ If the radiograph of extraction region shows one
    third of the root of succedaneous tooth is already
    calcified
    „ When the space left by prematurely lost primary
    tooth is greater than the space needed for the
    permanent successor as indicated radiographically
    „ If the space shows no signs of closing
    „ When succedaneous tooth is absent
    Appliance..
    vΠ vj 

    „ Band & loop „ Acrylic partial


    „ Crown & loop denture
    „ Lingual arch „ Full denture
    „ Palatal arch „ jemovable distal shoe
    „ Transpalatal
    „ Distal shoe
    „ Esthetic ant
    „ Band & bar
    Fixed space maintainer«
    a Fixed or fitted unto the teeth

    a Advantages:
     Band & crown require minimum or no tooth prep
     Do not interfere with passive eruption of abutment
    teeth
     Jaw growth is no hampered
     Permanent teeth are free to erupt
     Can be used in un-cooperative patient
     Masticatory functions is restored
    aDisadvantages;
     Elaborates instrumentation with expert skill is
    needed.
     They may result in decalcification of tooth material
    under the bands.
     If pontics are used it can interfere with vertical
    eruption of the abutment tooth.
    jemovable appliance..
    „ Used when more than 1 tooth has been lost in a quadrant

    „ The only alternative when there are no suitable abutment teeth

    „ Can replace occlusal function

    „ Advantages:
    „ Easy to clean
    „ jestore vertical dimension
    „ Can be worn part time allowing circulation of the blood to the ST
    „ joom can be made for permanent teeth to erupt without changing
    app
    „ Stimulate eruption
    „ Help in preventing dev of tongue thrust habit into the extraction
    space
    „ Disadvantages;
    „ Lost or broken
    „ Uncooperative patient may not wear the app
    „ Lat jaw growth may be restricted, if clasps are
    incorporated
    „ May cause irritation of the underlying ST
    „ Indication;
    „ Esthetic
    „ Abutment cannot support fixed app
    „ Cleft palate require obturation of the palatal
    defect
    „ Unerupted permanent is not going to erupt in less
    than 5 month time
    „ Difficult to adapt bands
    „ Multiple loss of primary which require functional
    replacement
    „ Contraindication;
    „ Lack of patient cooperation
    „ Allergic to acrylic
    „ Epileptic patient
    Acrylic Partial Dentures:
    „ Bilateral removable functional passive space
    maintainer
    „ Bilateral removable non-functional Space
    maintainer
    „ Used successfully in patients who have undergone
    multiple extractions.
    „ The inclusion of artificial teeth in the denture
    restores masticatory function.
    „ Clasp can be fabricated on deciduous canines &
    molars for retention.
    Full or complete dentures:
    „ In primary teeth of a pre school child where
    extraction is indicated for rampant Caries.
    „ These denture restore masticatory function and
    esthetics.
    „ =uide the first permanent molars into their
    correct position.
    „ Denture will have to be adjusted and a portion of
    it cut away as the permanent incisor erupt.
    jemovable Distal shoe space maintainer:
    „ An ¶immediate· acrylic partial denture with an
    acrylic distal shoe extension
    „ guide the 1st permanent molar into position when
    the deciduous second molar is lost shortly before
    the eruption of the first permanent molar
    „ The tooth to be extracted is cut away from the
    stone model and a depression is cut into the stone
    model to allow the fabrication of the acrylic
    extension.
    m 
    „ Used to maintain space of a single tooth
    „ Cheap
    „ Easy to fabricate
    „ Do not restore the occlusal function of the
    missing tooth
    „ Indication;
    „ Unilateral loss of the primary first molar before or
    after the eruption of permanent 1st molar
    „ Bilateral loss of a primary molar before the
    eruption of the permanent incisors
    m  
    „ Bonding the first primary molar for guidance.
    „ used in cases where the second primary molar is
    lost before the eruption of the first permanent
    molar.
    £ 
     
    „ Indication
    „ Bilateral loss of primary teeth on the mandibular
    arch during transitional dentition
    „ Maintenance of arch perimeter and incisor
    positions

    contraindicated in primary dentition


    „ Modification of LLA with omega loops
    „ Activation of loop helps flare anteriors with some
    distalising of permanent molars
    „ Modifies LLA with claps to prevent distal tipping
    of lateral incisors
    O   
    „ Nance(1947) described the ¶preventive lingual
    wire·
    „ Consist of bands on the upper molars, with the
    arch wire extending forward into the vault.
    „ Indicated for loss of multiple primary teeth in
    the maxillary arch
    „ Acrylic button increased stability
    „ Prevent tipping and rotation movements of molars
    „ Acrylic button may cause difficulty in maintaining
    hygiene in the rugae area
    ï  
    „ Prevent rotation around the lingual root, prevent
    loss of space.
    „ Indicated for bilateral loss of primary maxillary
    molars
    „ Hygienic
    „ May not prevent the mesial tipping of teeth
     

    „ Indication;
    Loss of primary 2nd molar before the eruption of the
    1st permanent molar

    „ Contraindication;
    „ Poor oral hygiene
    „ Medically compromised patient
    „ Disadvantages
    Over extension causes injury to the permanent
    tooth bud i.e. second premolar.
    if under extended it may allow the molar to tip into
    the space or over the band.
    Prevents complete epithelization of the extraction
    socket.
    j 
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