An intra alveolar type of space maintainer also known as willets distal shoe was given. A 12 month follow up was taken. Conclusion: In. Space maintainers are appliances used to maintain space or regain .. The only treatment alternative to the distal shoe space maintainer is a. Distal shoe space maintainer is a valuable part of the Paediatric Dentist’s armamentarium in those cases where the second primary molar is.

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Unfortunately patient did not turn up for follow up treatment and reported back to the department six months later with a swelling in the lower right back teeth region. Pulp therapy was carried out on lower left primary first and second molars and upper left primary first molar,followed by stainless steel crown. Conventional design poses various limitations in cases of premature loss of multiple deciduous molars.

Premature loss of the primary second molar prior xistal the eruption of the permanent first molar is often a challenging problem to the dentist in managing the developing dentition. It was decided to extract right first and second deciduous molars. Also there is evidence of an associated chronic inflammatory response [ 13 ].

Unsupervised Distal Shoe Appliance: A Case Report

A cost-effective maintainer for primary second molars. September 19, ; Accepted Date: The primary second molar served as a guide on the working model for calculating the horizontal length of distal extension. The erupted lower right first and second premolar were hypoplastic with brownish discoloration of enamel, severe pitting and irregularities of crown and hardly showed any root development. The vertical depth of intra-alveolar projection was calculated radiographically, and a cut was made in the cast and wire components were adapted using gauge wire.


Arrested development of a permanent tooth. Photograph after restoration of central incisors. Author information Article notes Copyright and License information Disclaimer. Support Center Support Center.

Unsupervised Distal Shoe Appliance: A Case Report | OMICS International

National Center for Biotechnology InformationU. Photograph showing fracture of both maxillary central incisors. The modified distal shoe appliance is time efficient, more stable, better accepted by the child and meets all the criteria for proper space maintainer. October 28, Citation: This case report describes an innovative modification of distal shoe appliance in cases of premature loss of multiple deciduous molars. It was then decided to remove the modified distal shoe appliance and the patient was closely monitored during the recall visits.

Access cavity preparation was carried out on lower right primary first and second molars and closed dressing was given. However it appeared that intragingival extension of distal shoe appliance was obstructing the eruption of mandibular second premolar Figure 3.

Space Maintainers: Types Of Space Maintainers

In the maxillary central incisors pulp treatment were done followed by composite build-up in maxillary right central incisor and fragment reattachment in maxillary left central incisor Figure 4.

Conventional design maintwiner a variety of problems in cases of multiple loss of lower primary molars prior to eruption of first permanent molar.

Distal shoe space maintainer is advised in case of early loss of second primary molar before eruption of first permanent molar. All the permanent incisors, first molars, maxillary first premolars and mandibular right second premolar were erupted.

Space Maintainers & Regaining

Please review our privacy policy. The appliance traditionally suggested as the treatment of choice is spacw distal shoe space maintainer [ 4 ]. Dental caries is one of the most common reason for the premature loss of primary teeth [ 1 ]. Anteriorly the wire component was made like lingual holding arch and posteriorly the wire component like distal shoe.


J Clin Pediatr Dent.

In the present case, the right first and second premolars showed hardly any root development showing signs of complete stoppage of root development.

Modified distal shoe appliance for the loss of a primary second molar: Arrested shooe tooth development has been reported as a consequence of pulpal infection of carious primary teeth [ 9 ]. Band and loop space maintainer – made easy. Home Publications Conferences Register Contact. Case Report A 4. Can’t read the image? But this type of design has certain disadvantages such as non-functional, difficulty in dista, and cannot be given in uncooperative patients [ 7 ].

So whenever restoration in primary molar is not possible and extraction is the choice, there is always a risk of losing space resulting in malocclusion. Agri and Aquaculture Journals Dr. As it is a bilateral appliance it is possible for it to create hindrance in the path of eruption of permanent mandibular incisors.

An erupting tooth adjacent toan edentulous area has a greater potential for space loss than fully erupted ones, indicating that clinical intervention should be considered [ 3 ]. Intraoral periapical radiograph showing modified distal shoe ten months after insertion.

Intraoral periapical radiograph showing modified distal shoe immediately after insertion. J Am Dent Assoc.