Fixed space maintainers

Components
OBand
OLoop/archwire
OSolder joint
OAuxillaries
ands
,nd types
OLoop bands:
OTailored bands
OPreformed seamless bands

,nd m,teri,
Area Dimensions
Anterior 0.003 x 0.125 x 2 inches
Bicuspids 0.004 x 0.125 x 2 inches
Molar (dec) 0.005 x 0.180 x 2 inches
Molars (perm) 0.006 x 0.180 x 2 inches
BAND FORMATON

Techniques
Direct formation
Preformed bands
ndirect bands
Direct formation
Steps
A.separation
Brass wire: Elasti
Brass wire: Elastic threads
0.015-0.020 inch soft brass wire. Elastic threads
Young patients with thick periodontal
membrane
Gentle force over prolonged time period
Painful Painless at insertion

BAND FORMATON

1. band pinching
2.festooning
3.trimming
4.folded flap method

,nd form,tion
. Direct b,nd form,tion: ( pinching )
Oband sLrlps are flersL conLoured ln nciso-gingival or occluso-gingival direction using
Johnson`s contouring pliers
OWeld the ends of the band material and make a loop
OHowletts band forming pliers are used to form the bands
OPosition on the tooth
Oband should bePinched on the cuspal areas & not on groove areas (difficult to
adapt band in groove areas)
O&pper molar band: pulled from palatal side (seam at mesiolingual
line angle)
OLowe molar band: pulled from buccal side (seam at mesiobuccal
line angle)
OThe two edges of the seam must be parallel to each other so that band rest uniformly
on the tooth surface
OWhen insufficient clinical crown height: peak band forming
Pliers may be employed on the teeth .




estooning
Oontouring of the band to follow gingival contour proximally
OLevel of the band adjusted at the marginal ridge
ODistal side require more trimming since crown is angulated
distally, thus lower position of the distal marginal ridge and
raised position of the gingival
%rimming
Reducing on the buccal and lingual surface if required
adjusting occluso-cervical length.
oder f,p method
OAfter formation of seam, cut off the excess
OFold the remaining portion on the lingual surface of the tooth
OSpot weld the folded over portion
Orimping may be required to produce a rolled retentive edge to the band
OOcclusal margins are approximately 1 mm below the proximal ridges
OGingival margins should extent 0.5 to 1.0 mm into the gingival sulcus ( chec k for
blanching and relieve the areas where it is seen)
OBuccally it should be just below the contact of opposing cusp
OLingually it should be just below the deepest portion of lingual groove

) Weding
OPortion of metal being joined melted and flowed together.
OElectric spot welding is usually done and is carried out with electric current being
forced to flow through a limited area on the materials to be welded
OResistance of material to electric current produces heat and cause fusion of the two
sufaces


) Sodering
OTwo metals are joined by intermediary metal of lower fusion
temperature
OSolders used are silver containing solder (silver + copper +zinc
+ tin)
OFlux used to reduce fusion temperature
OFinishing with green stone and poilishing with rouge
BANB & L00P SPACE NAINTAINER
Fixed, non functionaI, passive space maintainer

and and Loop crown and Ioop
ndic,tions

OPremature loss of first decicious molars
OWhen the unerupted molars more than 2 yrs from its clinical eruption &
root length is less than
OlL can also be glven ln bllaLeral posLerlor LoLh lossbefore Lhe erupLlon of permanenL anLerlors
ln Lhe mandlble where Lwo bands and loop space malnLalner can be glven lnsLead of
removable space malnLalner

Contr,indic,tions
OExtreme crowding and space loss
OHigh caries activity
dv,nt,ges
1.E,sy to construct.
2.nexpensive.
.E,siy ,djusted.
.ows eruption of perm,nent tooth.
5.Non inv,sive.
6.P,iness.

Dis,dv,nt,ges
Oseldom used for Space loss of more than one tooth
ONonfunctional (asticatory function not restored )
OGingival slipping of loop
Limitations
OLoss of 2nd deciduous molar before eruption of 1st premolar
#,tion,e
Premature loss of first deciduous molar leads to following sequale
ODistal shift of primary canine
OMesial shift of primary second molar and first permanent molar
OMesially erupting first permanent premolar along the mesial
surface of 2nd molar
OPermanent canine is blocked out of the normal alignment
Construction

OThe 2nd deciduous molar is usually banded
and: stainless steel material 0.005 inches in thickness
Crib: portion of the wire spanning the edentulous space
Loop 0.030-0.035 inch archwire loop is soldered to the band


OThe loop spans the edentulous space and contacts the primary
canine on its distal surface at the contact point (if below the
contact point, chances of it slipping gingivally)
OThe loop should not interfere with the erupting permanent
Tooth
odific,tions
OLoop on only one side, but less stable
OOcclusal rest on the tooth to prevent gingival slipping of the
loop. This may hamper the erupting permenant tooth.
Orown and loop, where banding is not possible or grossly
destructed crown
Orown and bar

Distal Shoe space maintainer
intra aIveoIar, eruption guidance space maintainer

The fixed distal shoe space maintainer was reported by Willets in 1932
ndic,tions
Early loss or removal of second primary molar to the eruption of first permanent molar
prior to the eruption of first permanent molar
an be used in cases of bilateral space loss in maxillary arch
Contr,indic,tions
nadequate abutment teeth due to multiple teeth loss
Poor patient cooperation
ongenitally missing first molars
Medical conditions like blood dyscrasias, HD, Rheumatic fever, DM or generalized
debilitation

Dis,dv,nt,ges
Overextension caused injury to permanent tooth budi.e.,second premolar
f under extended it may allow molar to tip into the space or overr the band
Prevents complete epithelialisation of the extraction socket
Ronnermann and Thilander (!(&() discussed the path of eruption and stared that drifting
takes place only after the eruption the bony covering .the lower first molar normaly
erupts occlusalward to contact first the distal crown surface and uses that buttress for
uprighting .isolated considered ectopic eruption
Construction
ommonly used distal shoe appliance was described by Roche in 1942.
t's a crown and bar or a band and bar type of appliance
The Roche's appliance had a V-shaped gingival extension as against Willets which had
a
bar extension
t can be fixed or removable
Dist, extension

On the lower arch, the contact area of the distal extension
should have a slightly lingual position over the crest of alveolar
ridge
On the maxillary arch the contact area of the distal extension
should have a slightly facial extension in order to prevent
rotations of tooth and appliance

varlous Lype of space malnLalner
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