An intra alveolar type of space maintainer also known as willets distal shoe was given. A 12 month follow up was taken. Conclusion: In. Space maintainers are appliances used to maintain space or regain .. The only treatment alternative to the distal shoe space maintainer is a. Distal shoe space maintainer is a valuable part of the Paediatric Dentist’s armamentarium in those cases where the second primary molar is.

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Conclusion The modified distal shoe appliance is time efficient, more stable, better accepted by the child and meets all the criteria for proper space maintainer. Please review our privacy policy. But in this patient no clinical problem was evident even after having the appliance for such a long period. The primary second molar served as a guide on the working model for calculating the horizontal length of distal extension.

So whenever restoration in primary molar is not possible and extraction is the choice, there is always a risk of losing space resulting in malocclusion. Dental caries is one of the most common reason for the premature loss of primary teeth [ 1 ]. After removal of the space maintainer, patient was regularly followed and it was found that on this side second premolar had completely erupted after one year eight months, although on the contralateral side it was present when first time patient reported to us.

Space Maintainers: Types Of Space Maintainers

In the present case, the right first and second premolars showed hardly any root development showing signs of complete stoppage of root development. Showing post-operative photograph of the mandibular arch 1.

In the maintainef central incisors pulp treatment were done followed by composite build-up in maxillary right central incisor and fragment reattachment in maxillary left central incisor Figure 4. The solder was allowed to flow between the buccal and lingual wire to create a guide plate on the right side of the posterior wire component. However poor retention and patient compliance are the major drawbacks with this appliance [ 6 ]. Maitainer it is a bilateral appliance it is possible for it to create hindrance in the path of eruption of permanent mandibular incisors.


Space Maintainers & Regaining

Preservation of the primary dentition until the normal time of exfoliation is one of the most important factor involved in preventive and interceptive dentistry. Distal shoe or intraalveolar eruption guidance appliance type of space maintainer was indicated in the ehoe case.

October 28, Citation: Anteriorly the wire component was made like lingual holding arch and posteriorly the wire component like distal shoe. Periodic recall appointment was advised to monitor the eruption of mandibular left second premolar. Photograph after restoration of central incisors.

Clinical examination revealed deep carious lesion and IOPA radiograph showed pulpal involvement in relation to lower right and left primary first and second molars and upper left primary first molar. In the present case, modification of distal shoe space maintainer was advocated because of inadequate abutments caused due to multiple loss of deciduous molars. As there was soe eruption of right first and second premolar prior to the eruption of right first permanent molar and the first permanent molar showed signs of eruption, the modified distal shoe appliance was removed before the eruption of right first permanent molar.

The distal shoe space maintainer chairside fabrication and clinical performance.

Developmental arrest of permanent tooth germs following pulpal infection of deciduous teeth. Distal shoe space maintainer is advised in case of early loss of second primary molar before eruption of first permanent molar.

Arrested permanent tooth development has been reported as a consequence of pulpal infection of carious primary teeth [ 9 ]. Find articles by Niharika Rai. Holding space to allow the teeth to erupt and to prevent impactions is valuable [ 2 ].

Treatment planning for the distal shoe space maintainer. Can’t read the image? Whereas, distal shoe space maintainer was present on the mandibular left side Figure 2.

Primary dentition plays a vital role in developing speech, mastication, aesthetic, prevention of bad oral habits and eruption of permanent teeth [ 12 ]. Modified distal shoe appliance for the loss of a primary second molar: Agri and Aquaculture Journals Dr. Support Center Support Center. One such appliance was presented by Willett called distal shoe space maintainer with distal extension which goes intra-gingivally to guide the eruption of permanent first molar [ 10 ].


Bilateral design of distal shoe was shod for unilateral loss of deciduous molars. Thus, it is required to modify the conventional designs according to the needs of the patient. The purpose of this case report was to present a side effect in a case of unsupervised distal shoe space maintainer which was placed in a child and not followed regularly. In the present case reported maintwiner, there was a premature eruption of right first and second premolars prior to the eruption of right permanent first molar.

Pediatr Dent Care 1: The distal shoe space maintainer remains an acceptable standard of care, with an extension subgingivally to a location mesial to the unerupted first permanent molar [ 5 ]. Prasanna Kumar Bhat1 Navin H. Case Report Open Access. The space maintainer was well-accepted by the child and his parents and was optimistic for the future of his dentition.

Pulp therapy was carried out on lower left primary first and second molars and upper left primary first molar,followed by stainless steel crown.

Band adaptations were made on lower left second deciduous molar and lower right deciduous canine. Premature eruption of the premolars.

Various treatment options have been suggested in case of premature loss of second primary molar before eruption of first permanent molar [ 89 ]. Considering the age of the child, position and developmental stage of both mandibular left premolars, it was decided to remove mandibular left first primary molar along with distal shoe appliance.

However, further clinical studies are needed to establish its feasibility and usefulness in paediatric dentistry. Photograph after eruption of premolars. Photograph showing fracture of both maxillary central incisors.

Author information Article notes Copyright and License information Disclaimer. An erupting tooth adjacent toan edentulous area has a greater potential for space loss than fully erupted ones, indicating that clinical intervention should be considered [ 3 ]. Dent Clin N Amer. Conventional design poses various limitations in cases of premature loss of multiple deciduous molars.