Lecture 4 Flashcards
What are the reasons for primary tooth loss?
- premature loss of primary teeth
- proximal carious lesions
- trauma
- orthodontic reasons (crowding & malalignment)
The loss of primary teeth may lead to:
- 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
What serves as the BEST space maintainers for permanent dentition?
Primary teeth
If premature extraction or early loss of primary tooth is unavoidable what is the next best treatment option?
placing a space maintainer
What does a space maintainer appliance do?
It maintains the extraction space for the settlement of the successor permanent teeth
Space maintenace is appropriate ONLY when:
- all unerupted teeth are at the normal stage of development
- adequate space is available
- all unerupted teeth are present
If a permanent successor will eruption WITHIN 6 MONTHS, is a space maintainer necessary?
NO
If more than 1/2 to 2/3 of the permanent root has formed, is a space maintainer necessary?
NO
We expect to see the tooth in the mouth when ____ of the root has developed
3/4
What situations would require other treatment approaches because space maintanenace is inadequate or inappropriate?
- space loss (not enough space available for permanent teeth)
- missing permanent teeth
- severe skeletal discrepancy
- severe crowding
- severe spacing
What are the four common FIXED appliances that are generally used to maintain space in the primary dentition?
- band and loop (crown & loop)
- lower lingual holding arch
- nance
- distal shoe
T/F: For a lower lingual holding arch fixed appliance all lower incisors must be erupted
True
Bands on the molars, transpalatal arch, acrylic piece holds the molar in place:
Nance
Band is placed on the first primary molar with an extension:
Distal shoe
Before eruption of the permanent incisors, if a single primary molar has been lost B/L what space maintainers are recommended?
A pair of band and loop space maintainers
(this is advisable because the permanent incisor tooth buds are LINGUAL to the primary incisors and often erupt lingually)
What do the band and loop space enable the permanent incisors to do?
They allow the permanent incisors to erupt without interference from a lingual wire
Do band and loops have good survical times?
No –> they survive about 18 months with cement failure as the most frequent problem
If we do not use a space maintainer with a premature loss of a deciduous second molar what happens to the first molar?
Permanent first molar may tip or move mesially
Similar appliance to space maintainer but is spring loaded:
Space regainer
What is space regainer used for?
Used to regain space when first permanent molar has already begun to drift into the space left by the primary molar
