|Mandibular space maintainersFixed bilateral SM Removable bilateral SM fixed unilateral SMRemovable unilateral SMDistal shoe||Maxillary space maintainersFixed bilateral SMFixed unilateral SMRemovable bilateral SM|
Space management is an important responsibility of the general dentist, the pediatric dentist and the orthodontist. The premature loss of primary teeth may cause loss of arch length, resulting in crowding of the permanent dentition, impaction of permanent teeth, esthetic difficulties, malocclusion, and other problems. We recommend prompt and appropriate space management therapies to help insure optimal lifelong dental health.
We will focus on the various types of space maintainers, when and how they are used, and how they are made. Our coverage will center on maintaining existing space once primary teeth have been lost prematurely, rather than on tooth movement.
For example, this panoramic radiograph shows the premature loss of the mandibular right second primary molar, resulting in the tipping of the first permanent molar and consequent loss of space. This is an example of space loss which could have been prevented if a space maintainer had been placed after the primary tooth was removed.
Fixed bilaeral SM
Mandibular fixed bilateral space appliances generally are preferred by clinicians over removable space maintainers. Fixed appliances are easier to maintain and they are less likely to be removed, damaged, or lost by the child. In other words, they need less patient compliance.
Removable bilateral SM
Removable appliance must be worn at least 14 hours per day. Hence, it is highly dependent on patient compliance. However, oral hygiene would be easier owing to its removable nature.
The appliances demonstrated in this photographs are used to replace missing maxillary anterior or posterior primary teeth. In other words, these space maintainers also serve as maxillary anterior or posterior prosthesis and provide better function and esthetic situation for the child.