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Space Maintainers – Types | Risks

A space maintainer is an appliance custom-made by a dentist or orthodontist in acrylic or metal. It comes both in the form of removable and cemented in the patient’s mouth, aiming to maintain the space open to permit the permanent tooth to erupt and come into place. They are needed when the primary molars are lost at an early stage due to trauma or disease. Usually, a space maintainer allows the permanent teeth to come up, or grow, into the right alignment with good tooth-to-tooth contact. It is not usually required to use a space maintainer in case of premature front teeth loss. However, removable partial dentures may be suggested as space maintainers if several front teeth are missing, and the patient’s look is affected.

Space maintainers are used to impeding the first molars’ movement, impeding the loss of space for other teeth, including the adult bicuspid and canines. If permanent first molars’ positioning is not correct, they can start drifting forward, hindering the bicuspid teeth from a proper eruption. The first bicuspids may also move forward, choking the way for the permanent canines to erupt correctly.   

Categories Of Space Maintainers

There are various types of space maintainers available. The dentist suggests considering the tooth’s location and the patient’s requirement. The space maintainers range from the very simplest to those with varieties of bands and wires. They can be constructed in different ways and used in various parts of the mouth. The space maintainers are classified broadly into four types; fixed or removable, and unilateral or bilateral. It is easy to remove the removable space maintainers. A fixed space maintainer is usually fixed to a tooth or more teeth. Fixation is mostly done by cementing the gap maintenance appliance in a proper place. Unilateral space maintainers are attached to one side of the mouth, and bilateral space maintainers are attached to both sides. Fixed space maintainers can also be categorized into unilateral or bilateral. Space maintainers also can be fixed on the mandibular or maxillary arch. Consequently, one could get a maxillary removable bilateral space maintainer or a mandibular fixed unilateral space maintainer for the right side. Countless variations are happening on these basic themes. For example, some space maintainers are generally used for missing anterior teeth. Some are used to preserve space for posterior unerupted teeth.

The fixed bilateral space maintainers on the mandibular arch often are called lingual arch space maintainers. Clinicians generally suggest these over the removable space maintainers. Fixed appliances are easier to maintain. They are less likely to be replaced, damaged, or lost by the patient. The mandibular lingual arch space maintainer is used in the primary dentition and the mixed dentition, where bands can be petrified to primary or everlasting molars, respectively. This is the most commonly used space maintainers. It is even used on occasion in the permanent dentition when bicuspids are missing, and maintaining space is necessary before orthodontic or prosthetic therapy. The disadvantages of a removable space maintainer appliance are that the patient may not wear it, and it is more subject to breakage or loss by the patient. To reiterate, most clinicians prefer to place fixed space maintainers if possible. A distal shoe space maintainer is also called a distal extension space maintainer. It is used to prevent the first permanent molars from moving with the early premature loss of the second primary molars. Another type of space maintainer is Nance Holding Arch, or it is also called a Nance Appliance. It is used in situations where the premature bilateral loss of maxillary primary teeth has happened. 

Risks Associated by With Space Maintainers

Among the significant risks of using a space maintainer is oral hygiene. If a patient’s oral hygiene is bad, then the gums may also become inflamed. In the worst case, inflammation can develop around the space maintainer too. Poor oral hygiene can stimulate the risk of tooth damage. Young patients may have some particular issue with the process of making and fitting a space maintainer. Certain types of space maintainers, especially the distal shoe, need frequent monitoring and adjusting. It is done to ensure the device does not impede the normal eruption of the permanent first molars into the mouth. Visiting the dentist regularly for oral examinations will help avoid any complication and keep all the risks at bay.

At Dr. Mohamed Ali’s office, San Francisco, Dr. Ali will thoroughly assess your mouth before recommending any treatment. If required, he might suggest some alternatives which are best suited for your needs. Dr. Ali’s hospital is decked with all the modern technologies like CT-Scan, Intravenous Sedation, Platelet Rich Fibrin, etc. to present nothing less than the best of services. The billing experts will inspect your insurance benefits. They will offer you a complete treatment plan with all the necessary arrangements. Every major dental and medical PPO insurance plans are accepted, including Medicare. There is also an in-office Plan for Health for those who don’t have any insurance. Also, we have partnered with various financial institutions like The Lending Club, Care Credit, Healthcare Finance Solutions to make your treatment extremely affordable. If you have any queries, feel free to ask. So sit, relax, and get sparkling white teeth. Call us today to schedule your consultation. You can reach us at 415.391.7751.                    

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