Early loss of primary teeth

Question 1

what is the importance of the primary dentition

Answer 1

role in childs growth and development, not only in terms of speech, chewing, appearance and the prevention of bad habits but also in the guidance and eruption of permanent teeth

Question 2

exfoliation of primary teeth and eruption of permanent teeth is a:

Answer 2

normal physiologic process

Question 3

what are the reasons for loss of primary teeth

Answer 3

• premature loss of primary teeth
• proximal carious lesions
  -trauma
• orthodontic reasons: crowding, malalignment

Question 4

what are the consequences of early primary tooth loss

Answer 4

• mesial migration of teeth
• malocclusion in permanent dentition
• crowding
• impaction of permanent teeth
• supraeruption of opposing teeth
• changing/redirecting the path of eruption
• loss of arch length
• decreasing arch-perimeter

Question 5

what is the best way to avoid these problems

Answer 5

to preserve the primary teeth in the arch until their normal time of exfoliation is attained

Question 6

what is the best space maintainer for the permanent dentition

Answer 6

• primary teeth

Question 7

what do we do if premature extraction or loss of tooth is unavoidable

Answer 7

to maintain arch space by placing a space maintainer

Question 8

what does a space maintainer applicance do

Answer 8

maintain the extraction space for settlement of the successor permanent tooth

Question 9

what is the indication for space maintainer

Answer 9

if premature extraction or loss of tooth is unavoidable due to extensive caries or other reasons

Question 10

space maintenance is appropriate when:

Answer 10

• all unerupted teeth are at the normal stage of development
• adequate space is available
• all unerupted teeth are present

Question 11

when is a space maintainer unnecessary

Answer 11

• if a permanent successor will erupt within 6 months
• if more than 1/2 to 2/3 of its root has formed

Question 12

when do we expect to see the tooth in the mouth

Answer 12

when 3/4 of the root is developed

Question 13

what are the situations where space maintainence alone is inadequate or inappropriate and other treatment approaches will be needed

Answer 13

• space loss- not enough space for permanent tooth
• missing permanent tooth
• severe skeletal discrepancy
• severe crowding
• severe spacing

Question 14

what are the types of space maintainers

Answer 14

• fixed: unilateral or bilateral
• removal: unilateral or bilateral

Question 15

what are the 4 common fixed space maintainers

Answer 15

• band and loop (crown and loop)
• lower lingual holding arch
• nance
• distal shoe

Question 16

when is band and loop space maintainer recommended

Answer 16

before eruption of the permanent incisors, if a single primary molar has been lost bilaterally

Question 17

why is the band and loop recommended

Answer 17

because the permanent incisor tooth buds are lingual to the primary incisors and often erupt lingually
- the bilateral band and loops enable the permanent incisors to erupt without interference from a lingual wire

Question 18

how long do band and loops last and why

Answer 18

only 18 months with cement failure cited as the most frequent problem

Question 19

what happens if the space maintainer is not used on the premature loss of deciduous second molar

Answer 19

the permanent first molar may tip or move mesially

Question 20

what is done when the space maintainer is not used on the premature loss of deciduous second molar

Answer 20

the process of regaining the space lost by drifting of adjacent teeth following premature loss of deciduous teeth is the tx of choice

Question 21

the space regainer is similar appliance to the space maintainer but:

Answer 21

it is spring loaded

Question 22

when is the space regainer used

Answer 22

when the first molar has already begun to drift into the space left by the primary molar