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Objective: The evidence base for the use of space maintainers is relatively sparce despite being used for decades after the premature loss of primary molars. This study aims to increase the dental evidence base via investigating retrospectively the success rates of prefabricated fixed and removable space maintainers inserted from 2019 to 2021 and followed up until February 2023 at a specialized university clinic and to identify reasons for any reported minor and major failure. The authors hypothesized that there is no significant difference in failure rates between fixed and removable space maintainers inserted after the premature loss of a single primary molar per quadrant. Method and materials: Patients' digital records were searched yielding 645 space maintainers. After the application of inclusion criteria, 157 (67%) fixed prefabricated space maintainers in 112 children and 77 (33%) removable space maintainers in 61 children were analyzed for an average of 18.4 ± 9.5 months. Results: Kaplan-Meier survival analysis with Mantel-Cox statistics showed an overall cumulative survival time of 31.6 months (SE = 1.15, 95% CI = 29.4 to 33.9). Major failure occurred significantly more in removable maintainers (n = 40/67, 59.7%), mostly due to loss of the appliance, compared to fixed space maintainers (n = 27/67, 40.3%; P < .001). The present study indicates that space maintainers were mainly placed in young children with high caries experience, where treatment was mostly possible using advanced behavior management. Conclusions: Fixed space maintainers had a significantly lower failure rate than their removable counterpart. However, both require continual repairs, preservation, or even replacement till the eruption of the permanent tooth. [ABSTRACT FROM AUTHOR]

Background: The band and loop space maintainer is used to maintain the missing space of deciduous molars which are lost early. When the second deciduous molar is lost prematurely, the stress on the first permanent molar during different degrees of development may vary when it is the abutment. The design and use of the space maintainer may also lead to damage of the loop. The purpose of this article is to use the finite element method to study the stress on the first permanent molar and the loop with or without occlusal contact, with the first permanent molar of four different degrees of development serving as the abutment. We aimed to guide the clinical design and use of the space maintainer. Methods: We developed finite element models of the mandibular first permanent molar and the band and loop space maintainer, and simulated alveolar bone, periodontal ligament (PDL), enamel and dentin. The four developmental stages were 1/2 (I), 2/3 (II), 3/4 (III) and full development (IV). Ansys Workbench was used to analyze the effects of root development and occlusal contact between the loop and the opposite jaw on abutment teeth and the loop. Abutment teeth were statically loaded vertically and obliquely with a force of 70 N. The loop was statically loaded vertically with a force of 14 N. The stress on all structures and the displacement trends of the loop were calculated. Results: The stress on enamel, dentin, PDL and alveolar bone were similar, and the concentration was consistent. But if there was occlusal contact, the loop produced maximum displacement at the near middle edge of contact with the anterior teeth. When the loop was in occlusal contact with the opposing occlusal tooth, the peak value of the equivalent stress on the space maintainer under vertical load was: group I > group IV > group III > group II, and the maximum principal stress peak change was: group I > group III > group II > group IV. The change of the equivalent stress peak value of the loop under oblique load was: group I > group III > group IV > group II, and the maximum principal stress peak change was: group III > group I > group II > group IV. When the loop was not in occlusal contact with the opposing occlusal tooth, the peak value of the equivalent stress on the space maintainer under vertical load was: group IV > group I > group II > group III, and the maximum principal stress peak change was: group IV > group I > group II > group III. The change of the equivalent stress peak value of the space maintainer under oblique load was: group I > group IV > group II > group III, and the maximum principal stress peak change was: group I > group IV > group II > group III. Conclusions: Our results suggested that whenever possible, choosing the teeth with nearly complete root development as the abutment of the space maintainer is advisable. The design and use of the band and loop space maintainer should avoid occlusal contact with the occlusal teeth to prevent deformation of the loop. [ABSTRACT FROM AUTHOR]

Background The band and loop space maintainer is used to maintain the missing space of deciduous molars which are lost early. When the second deciduous molar is lost prematurely, the stress on the first permanent molar during different degrees of development may vary when it is the abutment. The design and use of the space maintainer may also lead to damage of the loop. The purpose of this article is to use the finite element method to study the stress on the first permanent molar and the loop with or without occlusal contact, with the first permanent molar of four different degrees of development serving as the abutment. We aimed to guide the clinical design and use of the space maintainer. Methods We developed finite element models of the mandibular first permanent molar and the band and loop space maintainer, and simulated alveolar bone, periodontal ligament (PDL), enamel and dentin. The four developmental stages were 1/2 (I), 2/3 (II), 3/4 (III) and full development (IV). Ansys Workbench was used to analyze the effects of root development and occlusal contact between the loop and the opposite jaw on abutment teeth and the loop. Abutment teeth were statically loaded vertically and obliquely with a force of 70 N. The loop was statically loaded vertically with a force of 14 N. The stress on all structures and the displacement trends of the loop were calculated. Results The stress on enamel, dentin, PDL and alveolar bone were similar, and the concentration was consistent. But if there was occlusal contact, the loop produced maximum displacement at the near middle edge of contact with the anterior teeth. When the loop was in occlusal contact with the opposing occlusal tooth, the peak value of the equivalent stress on the space maintainer under vertical load was: group I > group IV > group III > group II, and the maximum principal stress peak change was: group I > group III > group II > group IV. The change of the equivalent stress peak value of the loop under oblique load was: group I > group III > group IV > group II, and the maximum principal stress peak change was: group III > group I > group II > group IV. When the loop was not in occlusal contact with the opposing occlusal tooth, the peak value of the equivalent stress on the space maintainer under vertical load was: group IV > group I > group II > group III, and the maximum principal stress peak change was: group IV > group I > group II > group III. The change of the equivalent stress peak value of the space maintainer under oblique load was: group I > group IV > group II > group III, and the maximum principal stress peak change was: group I > group IV > group II > group III. Conclusions Our results suggested that whenever possible, choosing the teeth with nearly complete root development as the abutment of the space maintainer is advisable. The design and use of the band and loop space maintainer should avoid occlusal contact with the occlusal teeth to prevent deformation of the loop.

Maintaining primary teeth until they naturally exfoliate is extremely important in preventive and interceptive orthodontics. Losing a primary tooth or a set of teeth prematurely can have various consequences. If the primary second molar is lost before the permanent first molar erupts, it is recommended to use an intra-alveolar space maintainer. This article discusses the use of a distal shoe appliance in cases where the primary second molar is lost before the permanent mandibular first molar erupts. [ABSTRACT FROM AUTHOR]

Background: Premature loss for deciduous teeth is defined as the teeth that fall out before approaching the time of eruption of their replacement permanent teeth regardless of the reason for the loss of the teeth. The premature loss of deciduous teeth can cause the teeth next to the edentulous area to shift and lose arch space causing permanent teeth to grow abnormally. Prevention can be done by using Mayne's space maintainer so that the negative impact of premature loss does not occur. Purpose: Report the fabrication of Mayne's space maintainer in premature loss case. Case analysis: The laboratory accepted a working model with a case of premature loss in tooth 74 and was asked to make the Mayne's space maintainer. Result: This appliance consists of a molar band attached to tooth 75 with a 0.9 mm loop that is soldered on the buccal of the molar band. Conclusion: It is concluded that fabrication of Mayne's space maintainer in the case of premature loss of tooth 74 includes the preparation of a working model, adjustment of the molar band on tooth 75, making the loop, followed by soldering the loop to the molar band, finally the finishing and polishing.

Abstract Background This study aimed to evaluate spatial changes in dental arches resulting from premature loss of first primary molars and assess the necessity of a space maintainer. Methods We searched the electronic databases PubMed, Cochrane Library, ClinicalTrials, and EMBASE. Split-mouth studies involving unilateral premature loss of a primary first molar were included. Quality assessment of selected studies made use of the ROBINS-I tool. Mean space differences were calculated for the D + E and D spaces, arch width, arch length, arch perimeter. Results Of the 329 studies considered, 11 split-mouth studies were selected, including 246 cases in the maxilla and 217 in the mandible from 477 individuals aged 5–10 years. Over the medium-term follow-up period (6–24 months), space loss was 0.65 mm in the maxillary D + E (MD 0.65, 95% CI 0.15–1.16, P = 0.01), 1.24 mm in the mandibular D + E (MD 1.24, 95% CI 0.60–1.89, P 0.05). Conclusions After premature loss of first primary molars, space can be lost, but the amount of loss would not affect arch width, length, or arch perimeter over the 6–24 months follow-up period.

Background: This study aimed to evaluate spatial changes in dental arches resulting from premature loss of first primary molars and assess the necessity of a space maintainer. Methods: We searched the electronic databases PubMed, Cochrane Library, ClinicalTrials, and EMBASE. Split-mouth studies involving unilateral premature loss of a primary first molar were included. Quality assessment of selected studies made use of the ROBINS-I tool. Mean space differences were calculated for the D + E and D spaces, arch width, arch length, arch perimeter. Results: Of the 329 studies considered, 11 split-mouth studies were selected, including 246 cases in the maxilla and 217 in the mandible from 477 individuals aged 5–10 years. Over the medium-term follow-up period (6–24 months), space loss was 0.65 mm in the maxillary D + E (MD 0.65, 95% CI 0.15–1.16, P = 0.01), 1.24 mm in the mandibular D + E (MD 1.24, 95% CI 0.60–1.89, P < 0.01), and 1.47 mm in the mandibular D (MD 1.47, 95% CI 0.66–2.28, P < 0.01). There was no significant change in arch width, length, or arch perimeter between the initial and follow-up examinations (P > 0.05). Conclusions: After premature loss of first primary molars, space can be lost, but the amount of loss would not affect arch width, length, or arch perimeter over the 6–24 months follow-up period. [ABSTRACT FROM AUTHOR]

The technique of three-dimensional (3D) printing is used for generating 3D objects using Computer-Aided Design software or 3D scanners. The employment of 3D printing in medical and dental fields is one among the foremost recent emerging trends since it has numerous advantages over traditional techniques in terms of patient-specific personalized care. The database was thoroughly searched using PubMed, Google Scholar, and Ebscohost with keywords such as 3D printing, additive manufacturing, study model, treatment planning, clinical approach, fluoride application, space maintainer, occlusal splints, endodontic procedures, rehabilitation, nasoalveolar molding, and so on. There were no restrictions made on the year of publication, but the articles published in English were evaluated. With the continual advancements within the technology, this paper is aimed toward reviewing the present literature on various applications together with its specific applications regarding pediatric dental practice.

The technique of three-dimensional (3D) printing is used for generating 3D objects using Computer-Aided Design software or 3D scanners. The employment of 3D printing in medical and dental fields is one among the foremost recent emerging trends since it has numerous advantages over traditional techniques in terms of patient-specific personalized care. The database was thoroughly searched using PubMed, Google Scholar, and Ebscohost with keywords such as 3D printing, additive manufacturing, study model, treatment planning, clinical approach, fluoride application, space maintainer, occlusal splints, endodontic procedures, rehabilitation, nasoalveolar molding, and so on. There were no restrictions made on the year of publication, but the articles published in English were evaluated. With the continual advancements within the technology, this paper is aimed toward reviewing the present literature on various applications together with its specific applications regarding pediatric dental practice. [ABSTRACT FROM AUTHOR]

Copyright of Clinical Orthodontics is the property of Dental Press International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Prosthetic appliances are essential for promoting the proper development of teeth, dental arches, and facial bones in children. Due to the constantly changing nature of a child's oral environment, these appliances must be temporary and require regular maintenance and adjustment to avoid impeding orofacial growth. A fundamental aspect of contemporary dentistry is re-establishing aesthetics. The absence of front teeth can cause appearance-related concerns in children. Personal appearance holds significant importance for children, particularly during adolescence. Even preschoolers, aged three to five, begin to cultivate a keen sense of body image and are increasingly aware of how they are perceived by both their peers and adults. We executed two cases in which natural teeth were used as replacements for artificial teeth in partial dentures. In the first case, we used the exfoliated natural teeth in a removable partial denture for aesthetic rehabilitation. This method leverages the natural tooth's inherent aesthetic qualities, proving especially valuable in the immediate replacement of anterior teeth, where appearance is critical. In another case, we utilized the natural teeth for the posterior region not only to enhance the patient's chewing efficiency but also to facilitate the eruption of unerupted succedaneous teeth. Additionally, using the patient's own teeth helps to achieve proper occlusion and comfort after the denture is placed, thus ensuring that patient expectations are met in both situations., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Pradhan et al.)

Primary teeth play a crucial role in functional, aesthetic and speech tasks. They are also responsible for maintaining the jaw space for successor permanent teeth. Thus, dentists should understand that extraction might be the easiest decision but not always the correct one, especially, in the case of multiple loss of primary molars. On the other hand, endodontic treatments should be accurately diagnosed - necrotic and irreversibly inflamed teeth - and performed with suitable dental tools and materials. Then it is important to provide a good sealing with a suitable final restoration. This case report discusses an approach for preserving a mandibular primary second molar which had a radiographic lesion in the mesial root and the furcation area with multiple loss of primary molars (before eruption of first permanent molar). This treatment was done by performing a root canal treatment (pulpectomy) just for the distal root and a hemisection procedure by extracting the mesial root, followed by applying SSC crown and space maintainer (band and loop). To conclude, this type of treatment should be temporary until the eruption of the first permanent molar and then changed to be a lingual arch appliance. Moreover, hemisection was a suitable alternative approach to extraction over 36 months of following up.

BACKGROUND AND OBJECTIVES: Fixed space maintainers are often used following primary tooth loss. In this process, selection of a proper band size for stainless steel crowns (SSCs) is often performed by trial and error, which increases the chairside time and risk of contamination of the tried bands with saliva, blood, and gingival crevicular fluid, necessitating their subsequent sterilization. This study is aimed at determining the proper size of prefabricated bands for all SSCs of primary second molars. MATERIALS AND METHODS: In this cross-sectional study, seven examiners, including three orthodontists and four pediatric dentists attempted to select the proper band size for 24 primary second molar SSCs (3M). They selected the proper band size for each size of SSC six times in three sessions. The significance of all selected choices was carried out using the test of proportions. RESULTS: The most commonly selected bands for EU2, EU3, EU4, EU5, EU6, and EU7 SSCs were sizes 31+, 32+, 34, 35+, 37, and 38, respectively, and the proper bands for EL2, EL3, EL4, EL5, EL6, and EL7 SSCs were sizes 30, 31+, 32+, 33+, 35 and 36+, respectively. The difference in the frequency ratio of different choices for all sizes of SSCs was significant (P < 0.05). CONCLUSION: The current study determined the proper band size for all SSCs of primary maxillary and mandibular second molars. This information can help dental clinicians in selecting the proper band size for SSCs without trial and error. [ABSTRACT FROM AUTHOR]

Background: Lingual holding arch appliance has been the most trusted space maintainer in the field of pediatric dentistry. This study put forward mapping of application of various designs of lingual holding arch appliance and to verify the main gap in the research on this field. Methods: This is a scoping review that took place in 2021 following PRISMA-ScR Guideline. Data was searched through the database PubMed, SCOPUS, Google scholar The search strategy included keywords’ bilateral fixed space maintainer’ ‘space maintainer’ ‘lower lingual holding arch’ ‘fixed lingual arch appliance’ ‘functional lingual arch holding appliance’ A total of eleven studies from nine hundred and thirty original articles were identified and were included and reviewed. The study selection and tabulation of data were performed by two independent reviewers. Any disagreement in study selection was resolved by a third reviewer. Conclusion: In the transitional phase, preventive and interceptive orthodontic plays a significant role in minimizing the inevitable developing malocclusion The mapping determined all proposed designs for the prevention of space loss. Each design needs to be carefully selected based on the phase of mixed dentition. This paper provides information on various designs of a lingual arch space maintainer, and it can be concluded that there is a necessity for long-term follow-up studies for further research in the field. [ABSTRACT FROM AUTHOR]

This study assessed parents' knowledge about space maintainers as an interceptive strategy after premature loss of primary teeth. Methods and Material: A cross-sectional questionnaire-based descriptive study was conducted on a sample of 600 parents; 456 (76%) were females, and 144 (24%) were males, recruited from an outpatient dental clinic at Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia. The questionnaire consisted of two sections; the first section collected sociodemographic data of participants, and the second section gathered parental knowledge of space maintainers. The research ethics committee granted ethical approval, and informed consent was obtained before participation. Results: 600 parents participated in this study. The total mean knowledge score regarding space maintainers was 7.97 ± 3.38. The mean knowledge score was 7.06 ± 2.99 for male parents and 8.26 ± 3.45 for female parents. The difference in the mean knowledge score between female and male parents was statistically significant (p < 0.001). Additionally, there was a statistically significant difference in the knowledge score and parents' age groups, with parents having the highest knowledge in the 30–40 age group (p = 0.0197). There was a positive correlation between knowledge scores and the number of children. Parents with one child showed less knowledge than those with two to four children (p = 0.0121). Conclusions: Participants' knowledge regarding space maintainers was 49.8%, which is considered inadequate. It was deemed essential to increase knowledge among parents about space maintainers as an interceptive approach after premature loss of primary teeth. [ABSTRACT FROM AUTHOR]

Background: Caries is one of the most common oral diseases that occur among children. Caries and dental trauma in children may cause early tooth loss, also known as premature loss, and result in occlusion abnormalities caused by the dental arch narrowing. A space maintainer is a preventive orthodontic appliance designed to maintain a narrow arch to prevent premature loss. Purpose: This study aims to describe the treatment of a case of space management in a patient with premature loss by using the space maintainer ‘Y model’. Case: An eight-year-old boy was accompanied by his mother, complaining that the lower posterior right tooth had been extracted. The mother was worried that the new tooth would have an overlapping growth. Case Management: The diagnosis was mandibular primary molar loss. The study cast was analysed based on Moyers 2.62 cm, Huckaba 2.24 mm, and curve determination 2.40 mm. The mandibular removable space maintainer treatment was performed on the patient and was followed by nine control visits every week. The outcome was a successful treatment from the use of the space maintainer ‘Y model’. Conclusion: The space maintainer treatment with the Y model in the paediatric patient showed a good result, evidenced by the tube opening of 1.2 mm, showing that the appliance followed lateral jaw growth.

Copyright of Journal of Ege University School of Dentistry / Ege Üniversitesi Dis Hekimligi Fakültesi Dergisi is the property of Ege University Faculty of Dentistry and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkiye Klinikleri Journal of Dental Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of the present study is to evaluate the quality and educational information provided on YouTubeTM about stainless steel crowns (SSC). Videos were searched for on YouTube TM using keywords related to stainless steel crowns in pediatric dentistry in the Google Trends application. A total of 52 videos were available. After exclusion criteria application, 22 videos were selected for the study for analysis. To classify the video content as high or low quality, a scoring system formed of seven parameters was used. For a global evaluation of the video quality, the video information and quality index were applied. Data obtained were analyzed statistically. Only a few videos explained the importance of SSCs. Most of the videos uploaded with a high number of likes were of low quality. Very few videos were of high quality. The content quality and educational quality of videos is poor and incomplete. None of the videos explained the need for the SSC and its benefits in pediatric dentistry. [ABSTRACT FROM AUTHOR]

Background: A space maintainer is an appliance used to maintain the jaw space due to the premature loss of deciduous teeth. Moyer’s method is used to determine the need for a space maintainer by measuring the discrepancy. Objective: The aim of this article is to determine the difference between measurements using Moyer’s method on a dental study model and on panoramic radiographs. Methods: Researchers measured the available space in 60 dental study models using two methods—the segmental method and contouring of the jaw arch using a 0.6 mm diameter arch wire. Moyer’s prediction table was used to predict the mesial-distal width of the permanent canines and premolars. Software ImageJ (SIJ) was used to measure the available space and required space on panoramic radiographs. We performed image calibration so that the measurement results could be presented in millimeters. Results: There was no significant difference (P = 0.935) in the discrepancy prediction between the panoramic radiographs and the dental study model. The Bland—Altman test result showed no significant difference, and the conformity between the panoramic radiographs and the dental study model was 0.02770. The sensitivity and specificity values of the panoramic radiographs and dental study model were above the 50% line. The area under curve values of the panoramic radiographs and dental study model were considered to be very good. Conclusion: Application of Moyer’s method to panoramic radiographs using SIJ to determine space maintainer requirements can be performed on pediatric patients to predict special discrepancies.

Introduction: It may be necessary to make some modifications to the removable space maintainers for the persuasion of children to use this device. However, modification of the polymethyl methacrylate (PMMA) may affect its mechanical properties as well. Therefore, the present study aimed to evaluate the effects of color and glitter on the flexural strength of PMMA. Methods: For the purposes of the study, 40 PMMA specimens (64 mm×10 mm×2.5 mm) were prepared and divided into 4 groups (n=10). For all groups, PMMA resin was mixed according to the instructions provided by the manufacturers. Group 1 was prepared with clear resin and served as the control group. Group 2 was prepared with clear resin and glitter. Group 3 was prepared as colored by adding color concentrate. Group 4 was colored similar to Group 3 and glitter was added as well. Finally, a three-point flexure test was used to measure the flexural strength of the specimens. The flexural strength was analyzed using the Kruskal–Wallis test. The Conover-Iman test of multiple comparisons was used to detect the differences among the groups. In all the tests, a P-value of 0.05 was considered statistically significant. Results: The PMMA with glitter showed statistically significant reduced flexural strength value, compared to clear PMMA. Moreover, the addition of color caused an insignificant increase in the flexural strength of PMMA. Conclusion: The addition of glitter to clear PMMA reduced the flexural strength of the material while other modifications did not

The following case report presents a new and innovative technique for the preservation of space due to tooth loss as well as the interception of anterior cross-bite. The novel appliance fabricated fully satisfies the demand of the adolescent patient, while fulfilling the esthetic and functional requirements presented by the case.

Context: Premature loss of primary teeth is one of the most prevalent dental problems affecting children worldwide. It is commonly caused by dental caries and trauma. Parents are responsible for their children's oral health and should pay close attention to the consequences of space loss. Aims: The aim of this study is to assess the prevalence of premature loss of primary teeth among children in Dammam city, Saudi Arabia and evaluate the parents' awareness toward space maintainers. Settings and Design: A cross-sectional study was planned to randomly select children aged between 4 and 9 years who attend governmental and private clinics in Dammam city. Materials and Methods: WHO criteria (WHO 1997) were used to examine decay-missing-filled index and premature loss of primary teeth. Questionnaires were distributed by hand to the parents of selected children to explore their demographic data and their awareness toward space maintainers. Statistical Analysis: Descriptive statistics were used to describe and summarize data collected numerically by SPSS version 20.0. The level of statistical significance was set at P < 0.05. Data from the questionnaires were analyzed using the following: frequencies, percentages, cross-tabulation, and Chi-square tests. Results: The mean dmf of the participated children in the study was 2.24 (standard deviation = 2.08). The prevalence of premature loss of primary teeth of the selected children was 20%. Only 37 (18.5%) out of 200 parents were aware about space maintainers. Conclusions: The current study revealed a high prevalence of premature loss of primary teeth among children in Saudi Arabia. The parents were unaware about the space maintainer, its used, maintenance, and benefits.

Introduction: Preserving primary dentition is essential for maintaining optimal oral health and development in children. Premature loss of primary teeth due to caries, infection, crowding, or trauma can necessitate orthodontic intervention and lead to various complications. Space maintainers are critical for preserving arch space until the eruption of permanent teeth, thereby preventing issues such as ectopic eruption, crowding, and malocclusion. Despite their advantages, prefabricated space maintainers (PSMs) are underutilized. This study aims to evaluate the knowledge, attitudes, and practices of Indian dentists regarding PSMs in primary teeth., Methodology: A cross-sectional questionnaire survey was conducted among 100 dental practitioners in Chennai. A 10-item self-administered questionnaire, developed based on a comprehensive literature review and expert consultations, assessed demographics, knowledge of PSM indications and techniques, current practices, perceived barriers, and preferences for continuing education. The questionnaire's reliability was confirmed with a Cronbach's alpha value of 0.85. Descriptive statistics, including frequencies and percentages, were used to summarize the participants' demographic characteristics, knowledge levels, and current practices related to PSMs., Results: Of the 100 respondents, 86 (86%) were males and 14 (14%) were females. Only 19 (19%) reported using PSMs, while 36 (36%) used conventional space maintainers. A significant proportion (42 (42%)) of the respondents held a master's degree in dental surgery, yet only 11 (11%) had participated in Continuing Dental Education (CDE) programs on space maintainers. The perceived benefit of PSMs being a single appointment procedure was acknowledged by 82 (82%) of the respondents, whereas 76 (76%) participants identified cost as a major drawback. Notably, 45 (45%) practitioners did not consider PSMs necessary., Conclusion: This survey highlights notable obstacles in the adoption of PSMs among Indian dentists, emphasizing the need for focused educational initiatives. Improving knowledge and practices related to PSMs can enhance pediatric dental care and oral health outcomes in India., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Human Ethical Committee, Saveetha Dental College issued approval IHEC/SDC/PEDO-2103/24/117. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Suresh et al.)

Background: Premature loss of primary teeth presents a significant challenge in oral health, with conflicting views on using space maintainers., Aim: To assess mandibular arch space changes associated with premature lower primary molar (PM) loss with or without a space maintainer., Design: A randomized clinical trial with children (6-9 years old) with premature loss of a lower PM divided into two groups: control group (CG), without a space maintainer, and intervention group (IG), with a space maintainer. Dental casts were measured at baseline, 3 months, and 6 months. Linear distance; intercanine width and length; and arch width, length, and perimeter were measured. ANOVA and t-test were applied (p = .05)., Results: Twenty-six patients (mean: 7.3 years; standard deviation [SD]: 0.92) were included: 14 in CG and 12 in IG. CG had a greater space loss (-0.9 mm; SD: 0.45) than IG (-0.4 mm; SD: 0.61) at 3 months (p < .05). No difference between the groups was observed after 6 months (p = .610). CG decreases space at 6 months, especially with the first permanent molars without intercuspation (-2 mm; SD: 0.71; p = .007)., Conclusion: Premature lower PM loss resulted in reduced arch space loss after 6 months, regardless of a space maintainer use. CG showed more loss of space when the first permanent molars lacked intercuspal relationship., (© 2024 BSPD, IAPD and John Wiley & Sons Ltd.)

Background: Primary teeth are important for eating, speaking, and esthetics, as well as for guiding the eruption and maintaining the space for the permanent teeth. The best space maintainers (SM) for permanent dentition are the natural primary teeth. The aim of this study was to assess parents' knowledge and awareness of the importance of primary teeth and SM in Saudi Arabia., Method: This cross-sectional study invited parents who were living in Saudi Arabia via different social media platforms to complete a validated questionnaire. The data collected included demographic characteristics, questions about parents' knowledge of their children's oral hygiene, and the importance of primary teeth, as well as questions about knowledge of SM., Results: A total of 392 participants completed the questionnaire. Dental problems and pain were the most common reasons for visiting the pediatric dentist (n=260; 66.3%). With respect to the age at which the first primary tooth erupted, more than half of the parents (n=270; 68.9%) knew the correct age. Only 43.3% (n=168) of the parents had received any information about SM and only 39.5% (n=155) of them knew their purpose., Conclusion: Most parents agree that treating primary teeth is important for their children's oral health and development. However, most are unaware of an SM's purpose. We recommend that dentists discuss SM's importance with parents actively after extracting their child's teeth. This will help increase parents' awareness and understanding of SM and encourage them to be more informed about this dental treatment option., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. The Biomedical Research Ethics Committee issued approval HAPO-02-K-012-2023-03-1507. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Redwan et al.)

Aim: This retrospective study investigated the survival rate and clinical performance of space maintainers fitted in 50 patients aged from 6-11 years in the Department of Pediatric Dentistry at Selçuk University, Faculty of Dentistry between 2016 and 2019. Methodology: Sixty-one subjects were included in the study. The clinical examination included performing the gingival index (GI) and the plaque index. The values of the indexes were determined and compared, and the failures of retainers were recorded and analyzed in terms of survival. Results: Follow-up loss occurred in 18% of 61 space maintainers. A total of 10% of the evaluated 50 space maintainers had failed due to breakage. By using the Kaplan-Meier method, the estimated mean survival time for space maintainers was 13 months. Lingual arches had the lowest mean survival time of 12 months. Band and loops and removable partial dentures had a similar probability of survival. A significant decrease was observed in the time-dependent evaluation of the means of plaque and gingival indexes; however, no significant difference was found between space maintainer types. Conclusion: The successful use of space maintainers for the premature loss of primary tooth space is achieved by regular follow-ups with the patient's parents, patient cooperation, and proper space maintainers and choice of material. [ABSTRACT FROM AUTHOR]

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Abstract Digital impressions improve patient experience and compliance. Digital impressions enable dental offices to collaborate and work with distant dental laboratories and specialists with ease. Although the initial cost of acquiring an intraoral scanner is significant, its use has the potential to reduce the cost per procedure.

Objective To evaluate the mechanical properties and bacterial adhesion of the glass fiber-reinforced composite resin space maintainer.Methods The mechanical properties of the composite resin high-strength fiber （experimental group） and the band and loop type （control group） space maintainer were tested by universal material testing machine. The two types of space maintainer were placed on a plate with a strain of Streptococcus mutans. Scanning electron microscopy and viable cell counts were used to observe bacterial attachment.Results There was no significant difference in the maximum shear resistance between the experimental group（32.02 ± 4.315）N and the control group （33.35 ± 5.154）N space maintainer （P > 0.05）. Scanning electron microscope showed that streptococcal bacteria were attached to the surface of the two groups. The colony count quantity of the experimental group （10.02 ± 2.315） ×104 CFU/mL was decreased compared with that of the control group （14.35 ± 2.154） ×104 CFU/mL. The difference was statistically significant （P < 0.05）.Conclusion The composite resin high-strength fiber and the band and loop type space maintainer have comparable mechanical strength; however, the composite resin high-strength fiber bacteria adheres less than the band and loop type, and the self-cleaning function is relatively good.

The purpose of the present study is to evaluate the quality and educational information provided on YouTubeTM about stainless steel crowns (SSC). Videos were searched for on YouTube TM using keywords related to stainless steel crowns in pediatric dentistry in the Google Trends application. A total of 52 videos were available. After exclusion criteria application, 22 videos were selected for the study for analysis. To classify the video content as high or low quality, a scoring system formed of seven parameters was used. For a global evaluation of the video quality, the video information and quality index were applied. Data obtained were analyzed statistically. Only a few videos explained the importance of SSCs. Most of the videos uploaded with a high number of likes were of low quality. Very few videos were of high quality. The content quality and educational quality of videos is poor and incomplete. None of the videos explained the need for the SSC and its benefits in pediatric dentistry.

This case report presents the successful management of a four-year-old male patient with pain in the lower right back tooth region. Clinical and radiographic examinations revealed the necessity for extraction of tooth 85 due to persistent infection and bone resorption, necessitating space maintenance. A modified distal shoe space maintainer, incorporating horizontal loops for enhanced adjustability, was utilized postextraction. The appliance was fabricated, cemented, and monitored through follow-up visits. At the 24-month recall, the permanent mandibular first molar (tooth 46) was clinically visible, indicating successful space maintenance. Incorporating horizontal loops into the distal shoe space maintainer represents an innovative approach in pediatric dentistry, offering clinicians a versatile tool for managing space loss and promoting optimal eruptive patterns., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Gupta et al.)

Purpose: Evaluation of survival rates for three space maintainers (SMs) of different designs compared to the standard one., Materials and Methods: A total of 52 extraction sites in children aged 4-7 years with prematurely lost primary molars were selected for this study. The whole sample was divided into four groups of 13 each. In group I, Band and Loop (B&L); group II, single-sided Band and Loop (Ss B&L); group III, Direct Bonded Wire (DBW); and group IV, Tube and Loop (T&L). Children were recalled at 3, 6, 9, 12, and 15 months. Cumulative survival rates of SMs were estimated using the Kaplan-Meier method with a logrank test., Results: Although there was a nonsignificant difference in the number of failed cases among all groups, the overall survival rate for group I was 69.2%, group II was 53.8%, group III was 38.5%, and group IV was 30.8% at the end of the study. The failure types for B&L were solder breakage (75% of the total failure rate) and cement dissolution (25%); for Ss B&L, they were solder breakage with lost loop (50%), soft tissue impingement (33%), and dislodgment (17%); for DBW, they were composite-wire interface debonding (75%) and enamel-composite interface debonding (25%); and finally, for T&L, they were lost T&L (56%), soft tissue impingement (22%), and total loss (22%)., Conclusion: Banded SMs survived for a longer time than bonded ones, with superior performance for B&L compared to Ss B&L. In addition, bonded SMs required strict isolation conditions. DBW could be used in the maxilla rather than the mandible and was preferable for older children., How to Cite This Article: Hemdan ME, H El Kalla IHH, El Agamy RA. Clinical Evaluation of Different Designs of Fixed Space Maintainer: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2024;17(4):442-450., Competing Interests: Source of support: Nil Conflict of interest: NoneConflict of interest: None, (Copyright © 2024; The Author(s).)

BACKGROUND AND OBJECTIVES: Fixed space maintainers are often used following primary tooth loss. In this process, selection of a proper band size for stainless steel crowns (SSCs) is often performed by trial and error, which increases the chairside time and risk of contamination of the tried bands with saliva, blood, and gingival crevicular fluid, necessitating their subsequent sterilization. This study is aimed at determining the proper size of prefabricated bands for all SSCs of primary second molars. MATERIALS AND METHODS: In this cross-sectional study, seven examiners, including three orthodontists and four pediatric dentists attempted to select the proper band size for 24 primary second molar SSCs (3M). They selected the proper band size for each size of SSC six times in three sessions. The significance of all selected choices was carried out using the test of proportions. RESULTS: The most commonly selected bands for EU2, EU3, EU4, EU5, EU6, and EU7 SSCs were sizes 31+, 32+, 34, 35+, 37, and 38, respectively, and the proper bands for EL2, EL3, EL4, EL5, EL6, and EL7 SSCs were sizes 30, 31+, 32+, 33+, 35 and 36+, respectively. The difference in the frequency ratio of different choices for all sizes of SSCs was significant (P < 0.05). CONCLUSION: The current study determined the proper band size for all SSCs of primary maxillary and mandibular second molars. This information can help dental clinicians in selecting the proper band size for SSCs without trial and error.

The early loss of deciduous teeth may lead to a decrease in arch length and result in crowding, rotation, and impaction of the succedaneous teeth. Space management plays a pivotal role in preventing these malocclusions. This study aims to assess the prevalence of Nance space maintainers among children between the age group of 6-10 years in Chennai. A retrospective cross-sectional study was conducted using the patient records from June 2019 to April 2020, and children who underwent space maintainer therapy were selected by non-probability sampling. Data was collected and then subjected to statistical analysis using Statistical Package for Social Science for Windows (version 20.0, SPSS Inc., Chicago Ill., USA). The prevalence of nance space maintainer among 6-10 year old children was found to be 76.5%, with most of them being delivered to 8 year olds. More males than females underwent nance space maintainer therapy. 53.85% of the 6-10 year olds receiving nance space maintenance therapy were found to be treated by the post graduate students (p>0.05, statistically not significant). The prevalence of nance space maintainer as a treatment option among the mixed dentition phase in this study seems to be high when compared to other studies. Considering the limitations of the nance appliance, extensive research needs to be done to find alternatives to nance space maintainer therapy and to spread awareness among dentists on the necessity of such further advancements. [ABSTRACT FROM AUTHOR]

The following case report presents a new and innovative technique for the preservation of space due to tooth loss as well as the interception of anterior cross-bite. The novel appliance fabricated fully satisfies the demand of the adolescent patient, while fulfilling the esthetic and functional requirements presented by the case. [ABSTRACT FROM AUTHOR]

Introduction: It may be necessary to make some modifications to the removable space maintainers for the persuasion of children to use this device. However, modification of the polymethyl methacrylate (PMMA) may affect its mechanical properties as well. Therefore, the present study aimed to evaluate the effects of color and glitter on the flexural strength of PMMA. Methods: For the purposes of the study, 40 PMMA specimens (64 mm×10 mm×2.5 mm) were prepared and divided into 4 groups (n=10). For all groups, PMMA resin was mixed according to the instructions provided by the manufacturers. Group 1 was prepared with clear resin and served as the control group. Group 2 was prepared with clear resin and glitter. Group 3 was prepared as colored by adding color concentrate. Group 4 was colored similar to Group 3 and glitter was added as well. Finally, a three-point flexure test was used to measure the flexural strength of the specimens. The flexural strength was analyzed using the Kruskal-Wallis test. The Conover-Iman test of multiple comparisons was used to detect the differences among the groups. In all the tests, a P-value of 0.05 was considered statistically significant. Results: The PMMA with glitter showed statistically significant reduced flexural strength value, compared to clear PMMA. Moreover, the addition of color caused an insignificant increase in the flexural strength of PMMA. Conclusion: The addition of glitter to clear PMMA reduced the flexural strength of the material while other modifications did not significantly affect the flexural strength of the PMMA. [ABSTRACT FROM AUTHOR]

Preservation of primary teeth until their normal exfoliation plays a crucial role in preventive and interceptive dentistry. Premature loss of the primary second molar prior to the eruption of the permanent first molar in the absence of the primary second molar can lead to mesial movement and migration of the permanent molar before and during its eruption. In such cases, an intra-alveolar type of space maintainer to guide the eruption of the permanent first molar is indicated. In certain cases, however, the conventional design is not practical. This paper describes a new design for distal shoe appliances in cases of primary second molar loss prior to the eruption of the permanent mandibular first molar. [ABSTRACT FROM AUTHOR]

Premature loss of primary tooth often leads to loss of arch circumference in primary and mixed dentition. It can lead to malocclusion and even impaction of permanent tooth germs. To maintain the space after loss of primary tooth, space maintainers are planned. These are imperative in maintaining arch integrity. The space maintainers that use CAD-CAM or 3D print technology with modern and biocompatible materials are called "digital space maintainer" or "digitainers". The materials used for the fabrication of digital space maintainer are polyetheretherketone (PEEK) polymer, Bruxzir, Trilor, etc. Patient acceptance with digitainers is extremely high. PEEK polymer is used in CAD/CAM OR 3D print technology, while Bruxzir allows better appliance retention, prevents tooth tipping, and distributes masticatory forces equally. Digitainers are esthetic, metal free, precise, takes less fabrication time, lightweight, single unit appliance, etc. However, they are expensive and lab assistance and fabrication expertise are required. PEEK polymer can be used in implant material, preformed pediatric crown, and obturators. While, Bruxzir is full strength monolithic zirconia material used for crown, bridges, screw-retained implant crown, inlays, etc. Digital space maintainer is an evolving and revealing fresh technique. The devices made using digital fabrication technique are reliable and long lasting. Since digital age has arrived and offers more advantages, clinicians would like to begin its use in regular practices. Thus, this poster aims to discuss about these newer materials, appliances, and techniques. [ABSTRACT FROM AUTHOR]

This article describes a novel technique for primary anterior tooth replacement using a new prosthetic system that requires minimally invasive dental preparation. The technique was used to restore the dentition of a 42-month-old girl with extensive loss of tooth substance. [ABSTRACT FROM AUTHOR]

Background/purpose: The consequence of premature loss of primary teeth resulting in the need for space maintainers has been controversial for many years. There is no longitudinal long-term report in literature regarding the premature loss of a primary maxillary first molar. The aim of this study was to continue observing the long-term space changes of 19 cases following premature loss of a primary maxillary first molar during the transition from primary to permanent dentition. Materials and methods: Ten of the 19 original participants were excluded because of extensive decay or loss to follow-up. Nine children (mean age at time of tooth extraction, 6.0 ± 0.42 years) with unilateral premature loss of a primary maxillary first molar were examined. Maxillary dental study casts were obtained 2 days or 3 days after tooth removal and, on average, 81 months later. The contralateral intact primary molars in each participant served as controls. The arch width, arch length, intercanine width, intercanine length, and arch perimeter of each study cast from the initial and follow-up examinations were measured and compared using paired t-tests. Results: Eight of nine cases (88.9%) did not show crowded permanent successors or canine block-out at the extraction site. Interestingly, the permanent dentition was more crowded at the control site (2/9) than at the extraction site (1/9). The arch width, arch length, intercanine width, and intercanine length significantly increased at 81 months (P

Early loss of deciduous teeth is a common problem in pediatric dentisty, can be associated with traumas of the anterior region of early childhood caries (ECC), ectopic eruption among others, and can cause occlusal damage and other undesirable aesthetic-functional squeal. The preparation of a functional - aesthetic space maintainer device is one of the most used treatment options in this type of condition; Among the indications of this, is the functional, phonetic and aesthetic recovery in order to prevent emotional disorders in children, improve the social aspect and preserve the correct dimensions of the arch, avoiding occlusal disharmonies. Within the main space mantainer devices we the partial anterior prosthesis of the Denari tube-bar system. This clinical case report shows the importance of the esthetic - functional maintainer, the correct preparation and clinical application in early childhood, orienting the professionals who treat pediatric patients. [ABSTRACT FROM AUTHOR]

Objective To evaluate the fatigue resistances of glass fiber reinforced composite resin (GFRCR) space maintainers and to compare the fatigue resistance of GFRCR space maintainers made of two different kinds of composite resins.Methods 40 extracted human molars were selected. Samples were randomly divided into two groups (n = 20). Space maintainers in group A were made of Z350 composite resin, while space maintainers in group B were made of Grengloo composite resin. All the specimens were exposed to temperature alternating between 5~55 ℃. Then they were placed on the cyclic loading machine to bear cyclic loading and the number of loading times were recorded. The results were compared with standard fatigue strength.Results The fatigue resistances of two groups were higher than standard fatigue resistances (P < 0.001). The fatigue resistances of two kinds of space maintainers showed no difference (P = 0.886).Conclusion According to the fatigue resistances, GFRCR space maintainers can be clinically used. There were on differences between two kinds of materials in making GFRCR maintainers.

Objective To observe the clinical efficacy in patients treated with two different eruption blocking appliances.Methods Totally 40 children (21 boys, 19 girls), aged 6.5-8.5 years old, having premature eruption of permanent tooth were randomly divided into 2 groups,with 20 cases in each group: group A (wearing traditional band and loop appliance of eruption blocking during the whole day) and group B(wearing modified band and loop appliance of eruption blocking during the whole day). The patients had regular check every 3 months until the root of premature premolar developed 1/2. The efficacy of the two appliances was evaluated on the following aspects: space maintenance, losing ratio of bands, tooth mobility and prevalence of dental caries of the premolars.Results The efficacy on space maintaining and eruption impaction were not statistically different (P > 0.05), but prevalence of dental caries of the teeth in group A was higher than that of group B (P < 0.05). Conclusion The modified band and loop appliance of eruption blocking is effective and good for tooth health.