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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