Clinical Technique: Removable Appliance Therapy for Space Maintenance Following Early Loss of Primary Molars

  • A. KupietzkyEmail author


Background: Premature loss of the second primary molar, prior to the eruption of the first permanent molar in the absence of the second primary molar, may lead to mesial movement and migration of the permanent molar before and during its eruption. The traditional appliance has been the distal shoe space maintainer, but fabrication and placement can be quite complicated. Clinical technique: The use of the removable appliance is described and advocated, although this treatment method was described over 20 years ago but has not gained widespread use. The purpose of this paper is to reintroduce the technique and present its clinical use allowing the permanent molar to erupt into proper position. Treatment: Acrylic removable appliances, these days with multi-coloured acrylics to make them attractive to children, are used. A minimum amount of wire clasps may be used for retention of the appliance. Ball clasps and 3/4 clasps are recommended and seldom are Adam’s clasps used. In most cases, the appliance is used as an interim treatment, however, if the appliance is to be present long term, its design will need to take into consideration canine movement and development. Follow-up: This should be at 3 month intervals with an emphasis on good oral hygiene and cleaning of the appliance.

Key words

space maintainer primary molars 


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Copyright information

© European Archives of Paediatric Dentistry 2007

Authors and Affiliations

  1. 1.Department of Pediatrie DentistryHebrew University, Hadassah Faculty of Dental MedicineJerusalemIsrael

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