I. Intra-arch Management
    A. Space Maintainers
        1. Band and Loop
            a. Unilateral single tooth loss
            b. First primary molar space
            c. Can be used in either dental arch   
        2. Lingual Arch
            a. Bilateral mandibular tooth loss
            b. Unilateral multiple tooth loss in mandible
            c. Single second primary molar loss in mandible
        3. Nance Appliance
            a. Bilateral maxillary tooth loss
            b. Unilateral multiple tooth loss in maxilla
            c. Single second primary molar loss in maxilla
        4. Distal Shoe
            a. Early loss of second primary molar
            b. Unerupted six year molar
    B. Space regainer- Humphrey appliance
        1. Ectopic maxillary permanent molar
        2. Stable second primary molar

 II. Inter-arch Management
    A. Cross-bites
        1. Posterior-- single tooth= Cross Elastics
        2. Posterior-- segment
            a. W-Arch appliance
            b. Quad-helix appliance
        3. Posterior-- skeletal bilateral= Rapid Maxillary Expander
    B. Open Bites
        1. Behavior Modification Program
        2. Habit Appliances
III. Banding and Impression
    A. Banding
        1. Select tight-fitting bands
        2. Place on teeth with fingers
        3. Push into place with band-biter
            a. Use corner of biter to seat with finger pressure
            b. Have child SLOWLY squeeze band down with teeth
        4. Good fit
            a. Must have no gaps at occlusal aspect
            b. Should not be removable with fingers
            c. If criteria are not met, use half size smaller
    B. Impression
        1. Alginate
            a. Quick setting will be easier
            b. Remove band and place into impression
            c. Use "staple" to hold band in place/keep from floating
            d. Pour and send to lab
        2. Alginate/compound technique
            a. Warm some compound and place around banded tooth
            b. Repeat steps listed above

IV. Types of Space Maintainers/Regainers
    A. Soldered, custom appiances
        1. Strong, accurate
        2. Well-contoured
        3. Will not interfere with erupting permanent tooth
    B. Pre-formed
        1. Very fast to make
        2. No impressions or lab bills
        3. More fragile
        4. Potentially disruptive to new permanent tooth

  V. Case Reports


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