Space Maintenance

Question 1

If you lose the baby first molar BEFORE the permanent first molar comes in, do you need space maintenance?

Answer 1

Yes

Question 2

If you lose the baby first molar AFTER FULL ERUPTION of the permanent first molar, is space maintenance indicated?

Answer 2

No

Question 3

You always need space maintenance when you lose this baby tooth, UNLESS the permanent successor is coming in pretty soon.

Answer 3

Primary second molar

Question 4

Space maintenance is NOT indicated for early loss of which teeth?

Answer 4

Primary incisors

Question 5

Space maintenance is usually not indicated for early loss of this tooth.

Answer 5

Primary canines.

Question 6

Rarely, what kind of space maintainer is placed with early loss of the primary canine?

Answer 6

LLHA

Question 7

This space maintainer is only in the maxillary arch.

Answer 7

Nance and Transpalatal arch (TPA).

Question 8

Band on the posterior tooth, and wire arms passively touch the tooth in front of the space.

Answer 8

Band and loop

Question 9

This space maintainer becomes useless once the anterior tooth exfoliates.

Answer 9

Band and loop.

Question 10

Best for loss of the first primary molar.

Answer 10

Band and loop.

Question 11

Indicated for uni or bilateral maxillary tooth loss, and the bands are usually placed on the max permanent first molars, or the max baby second molars if the permanent first molars haven’t erupted yet.

Answer 11

Nance

Question 12

Same indications as the Nance, but the wire runs straight across the palate.

Answer 12

Transpalatal arch

Question 13

Wire sits passively on the cingula of the lower anterior teeth.

All four mandibular incisors should be fully erupted.

Answer 13

LLHA (Lower Lingual Holding Arch)

Question 14

What can be added to a LLHA to allow for adjustment (especially if not all the lower 4 incisors have erupted)?

Answer 14

Omega loops

Question 15

Bad thing about placing a LLHA when all the lower incisors haven’t erupted yet?

Answer 15

The erupting permanent tooth can get stuck under the wire.

Question 16

Indicated when you lost the primary second molar BEFORE the adult first molar erupts.
It essentially holds the spot for the adult premolars to come in.

Answer 16

Distal shoe.

Question 17

Where does the band go on the distal shoe?

Answer 17

Primary first molar

Question 18

Must have a stable primary first molar to hold this band.

Answer 18

Distal shoe

Question 19

Where does the metal shoe sit ?

Answer 19

Subgingivally against the unerupted adult first molar.

Question 20

Contraindicated on any patient with an immune response.

Answer 20

Distal shoe

Question 21

This band must be replaced once the permanent first molar comes in.

Answer 21

Distal shoe

Question 22

Indicated for when you lost the primary second molar when the adult first molar hasn’t fully erupted.

Answer 22

Reverse band and loop.

Question 23

Where does the band go on the reverse band and loop?

Answer 23

Primary first molar.

Question 24

When is the reverse band and loop placed in relation to the adult first molar?

Answer 24

When you first see the mesial marginal ridge of the adult first molar.

Question 25

Space maintainers for when you lose the primary second molar before the permanent first molar either is fully erupted or hasn’t erupted at all.

Answer 25

Distal shoe

Reverse band and loop

Question 26

How long does the space maintainer stay in place for?

Answer 26

Until the permanent tooth begins to erupt.

Question 27

Home Care instructions for the space maintainer.

Answer 27

Brush like fornmal.

No sticky candies.

Return to clinic if it comes unglued.

Takes a few days to get used to.

Will check the cementation at every recall.

Question 28

After placing a space maintainer, what must you always do?

Answer 28

Take a radiograph.

Question 29

Do you need space maintenance if the permanent successor is going to erupt within 6 months?

Answer 29

No

Question 30

Do you need space maintenance if there’s no permanent successor?

Answer 30

No

Question 31

When does most space loss occur?

Answer 31

Within the first 6 months of losing the primary tooth.

Question 32

Can’t use this space maintainer if immunocompromised.

Answer 32

Distal shoe

Question 33

Space maintenance rule for the primary first molars.

Answer 33

If the 6 yr molar is in occlusion or the LI is in occlusion, DON’T need a space maintainer.