Early treatment of dental arch problems. I. Space maintenance, space gaining.
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The maintenance of arch length in the primary, mixed and early permanent dentition is important for the normal development of the occlusion. Premature loss of primary teeth can result in the loss of arch length leading to malocclusion. Space maintenance can often prevent space loss and either prevent the development of a later malocclusion or reduce its severity. The pattern of space loss depends on many factors including age, stage of development, which teeth have been lost, the presence of crowding or spacing, and occlusal relationships. Careful consideration of many factors is required when deciding whether space maintenance is indicated. Radiographs and space analysis can be helpful. Space maintainers can be fixed or removable. Band and loop space maintainers have fewer problems than other types. Frequent follow-ups to check for any problems following space maintainer insertion is recommended.
Space maintainers are very important in the prevention of malocclusions. Their indications and limits are described.
This manuscript provides the current standard passive space maintenance recommendations and identifies the appropriate space maintainer for premature loss of teeth in the primary dentition, early mixed dentition, and late mixed dentition.
An aesthetic solution is offered to the problem of space maintenance following the re-opening of space for an upper central incisor.
Early extraction of carious primary teeth may result in functional and/or loss of arch length problems. That is the rationale behind root canal therapy and/or space maintenance after the extraction of pulpally involved primary molars. What follows is a short radiographic and photographic history of unexpected results in well established and routine space therapy treatments.
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The importance of the loss of space in a context of preventive ortodoncy, is highly underlined in this kind of work.
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Five types of space maintainers were placed in 196 children participating in an extensive dental care program during a four-year study. Children with space maintainers were examined at six-month intervals. During the study, some sort of difficulty was encountered with 43% of the appliances inserted. The most common problem encountered was lost or missing appliances. Sixteen appliances had broken arch wires or loop wires; only ten broken bands were noted. Anther problem was distortion of arch wires. Suggestions are made for possible modifications in the space maintainers to reduce the incidence of problems.
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