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
©PSILENT PRODUCTIONS, 2004