Comparative Evaluation of Survival Rate Gingival Health and Patient's Acceptance of Conventional Band and Loop and Prefabricated Band and Loop in Primary Teeth: An In Vivo Study.

Aim: To compare and evaluate the survival rate, gingival health, and patient acceptance of traditional band and loop (B&L) and company-made B&L space maintainers in deciduous teeth-an in vivo study. Materials and methods: A total of 50 patients between 4 and 9 years of age-group, having loss of deciduous first molar in any of the arches, were included in the present study, which was divided into two groups. Group I consisted of the conventional B&L group, and group II consisted of the prefabricated B&L group. Results: The two groups showed no statistical significance in the 1st month, 3rd month, and 6th month in cement loss, failure of soldering, distortion of B&L fracture. The survival rate for the conventional group was 92%, whereas for prefabricated group was 100% at 6 months of follow-up. Company-made B&L showed significantly better gingival health (p = 0.004) at 6 months of follow-up and a better patient's acceptance rate. Conclusion: Prefabricated B&L appliances are newly developed space maintainers that are superior to conventional B&L appliances as they have a higher success rate and are more rational in design. How to cite this article: Dutta S, Gupta S, Tripathi P, et al. Comparative Evaluation of Survival Rate Gingival Health and Patient's Acceptance of Conventional Band and Loop and Prefabricated Band and Loop in Primary Teeth: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(S-1):S73-S77.

Guidance of Erupting First Permanent Molar in Complex Clinical Scenarios: A Case Series.

Aim: The aim of this current case series is to propose various design modifications of the conventional distal shoe space maintainers in relation to complex clinical scenarios. Background: Primary dentition plays a significant role in preserving space for underlying unerupted permanent teeth; early childhood caries (ECC) is a serious public health problem in both developing and developed countries, and it is often left untreated. Its consequences can have an immediate and long-term impact on the child's quality of life and overall health. Premature loss of primary dentition can result in loss of arch length, thereby hampering the eruption of the succeedaneous tooth, which can further lead to malalignment, crowding, rotation, and impaction of the permanent teeth. Space maintainers are advocated in cases where extraction of primary molars is inevitable. In the early loss of the second primary molar, a distal-shoe space maintainer is advocated to guide the eruption, as well as prevent mesial migration of the first permanent molar (FPM) during the eruption. In clinical scenarios where multiple losses of deciduous molars occur bilaterally, obtaining adequate anchorage is questionable and futile. The following clinical modifications, however, are useful in overcoming the problems related to the same. The following case series intends to project various modifications of distal shoes in complex scenarios. Case description: Various modifications of the distal shoe have been proposed in our current case series. The appliances were adjusted individually on a case-to-case basis depending on the clinical scenario. A 1-year clinical follow-up was carried out on all the patients. Conclusion: All the clinical modifications were successful in guiding the eruption of a FPM; there were no complications during any follow-up visit. Clinical significance: In cases where the traditional design is not indicated, certain modifications in distal shoes by adding new components to the appliance will allow the appliance to be placed and the space to be maintained effectively. Along with this, reinforcement of parents and the child for oral hygiene maintenance will maintain the remaining healthy tooth structure and increase the success of treatment. How to cite this article: Gunjal PY, Chauhan RS, Tirupathi S, et al. Guidance of Erupting First Permanent Molar in Complex Clinical Scenarios: A Case Series. Int J Clin Pediatr Dent 2024;17(3):362-367.

Clinical application of a digital semi-rigid bridge space maintainer fabricated from polyetheretherketone for premature loss of primary molars.

BACKGROUND: Premature loss of primary molars can be treated with a band loop space maintainer (SM). However, fabricating a conventional band loop SM requires multiple clinical and laboratory procedures, which can potentially affect the accuracy of the SM. Moreover, the conventional SM is unable to fully restore masticatory function and maintain the vertical dimension of the edentulous space. In this current study, a fully digital workflow to fabricate a semi-rigid bridge SM made from polyetheretherketone (PEEK) has been described and evaluated for its clinical effectiveness. METHODS: A total of 15 children (eight males and seven females) between the ages of 4-8 years, who experienced the premature loss of a single primary molar, were included in this study. Digital impressions were taken using the CEREC CAD/CAM chair system and imported into CAD software to design the semi-rigid bridge SM, which was fabricated using PEEK block as the maintainer material. The digital SM was tried-in and bonded to the abutment with resin cement. The edentulous space was measured immediately after bonding (T0) and 1 month (T1), 3 months (T2), and 6 months (T3) after treatment. The periodontal condition and mobility of the SM and abutment were also examined. RESULTS: The use of digital impressions resulted in a decreased occurrence of the pharyngeal reflex. The digital semi-rigid bridge SM, fabricated with PEEK, was both convenient and aesthetically pleasing, and successfully restored the anatomy and masticatory function of the missing primary molar. None of the 15 semi-rigid bridge SMs or abutments became loose or fell off during the study, and only one child presented with gingivitis. Furthermore, the difference in the edentulous space at T0, T1, T2, and T3 was not statistically significant (all P > 0.05). CONCLUSIONS: The digital semi-rigid bridge SM fabricated with PEEK was clinically effective in maintaining the missing space and had advantages over the traditional band/crown loop SM.

Application of Moyer's mixed dentition analysis and establishing probability tables in a sample of Pakistani population.

Objective: To assess the congruity of Moyers' dental analysis in Pakistani individuals and to make tables foreseeing the size of non-erupted permanent premolars and canines in children. Methods: A cross-sectional study was conducted at Orthodontics Department of Armed Forces Institute of Dentistry (AFID) Rawalpindi, Pakistan. This was conducted from January 2020 to December 2021 and included mixed dentition subjects' casts. Mesiodistal widths (MDW) of the permanent dentition were estimated and contrasted with the anticipated values that emerged from the Moyer's mixed dentition examination. Students t-test, simple linear regression and Pearson correlation coefficient examination were utilized for statistical correlation. All data was gathered utilizing an electronic digital caliper and further investigated through IBM SPSS Statistics 24. Results: Dental casts of the 258 subjects, 106 (41%) males and 152 (58.9%) females with the ages ranging 15.825±2.95 years were analyzed. Tooth size contrasts were significant (p <0.05) which was noticed in comparison to Moyer's predictive table. This demonstrates a bigger tooth size in young men than in young ladies. New probability tables were created through linear regression equations for our population. Conclusion: Moyer's prediction cannot be applied to the Pakistani population. Mandibular incisors in addition to maxillary first molars are superior in prediction for the size assessment of canines and premolars (cp) that are unerupted in males and upper arch only in females. Another noteworthy conclusion is that in our study sample, in lower arch of females, the width of mandibular molars with mandibular incisors predicts better.

Modified Surgical Stent in Management of Odontogenic Cyst in Mixed Dentition: A Report of Two Cases.

The treatment choice in the management of odontogenic cysts in the mixed dentition period depends upon the size, location of the cyst, the bone integrity of the cystic wall, and its proximity to vital structures. Enucleation is indicated with smaller cysts, achieved by careful removal of a complete cyst without rupturing the cystic lining. Marsupializationand decompression are the treatments of choice for larger cysts as it can help to preserve the tooth bud of the successor tooth and reduce morbidity. Marsupialization is achieved by opening and deroofing the cyst, and making the cystic lining continuous with the oral cavity or surrounding structures by suturing the edges of the incised mucosa to the cystic wall. This helps in maintaining the patency of the cystic lesion. In the decompression, a cylindrical device (drain) is placed in the lesion, which maintains communication between oral cavity to cystic lesion. This decreases the intracystic pressure and results in bone formation. We present two cases of odontogenic cyst in children, where we used a modified decompression technique. We developed a modified surgical stent with the use of a Hawley's appliance, which led to cystic decompression, and eventual eruption of the successor tooth. Notably, this modified technique also reduced both patient discomfort and the number of clinical visits, making it an effective treatment option. The unique design of the appliance also acted as a space maintainer for the eruption of successor tooth, which is very critical in mixed dentition for future prevention of space loss and eventual malocclusion. The advantage of our design was its easy removal and insertion with minimal discomfort.

Clinical effectiveness of space maintainers and space regainers in the mixed dentition: A systematic review.

BACKGROUND: The aim of this systematic review was to address the clinical effectiveness of space maintainers and space regainers in the prevention and correction of dental arch decreases in mixed dentition. METHODS: An electronic search was conducted using five databases: the Cochrane Database for Systematic Reviews, EBSCO Host, ScienceDirect, PubMed, and Scopus (until February 2021) and 6 relevant journals. Inclusion criteria were: Randomized Controlled Clinical Trials (RCTs), Controlled Clinical Trials (CCTs), cohort studies and case-control studies of children in the mixed dentition requiring a space maintainer or a space regainer, children with mild to moderate crowding, and with Class I and mild Class II or Class III skeletal pattern. All articles included in this review were examined independently by three teams of investigators to assess the level of bias using the Cochrane risk of bias tools RoB 2.0 (for RCTs) and ROBINS-I (for non-RCTs). RESULTS: Following the three phases of a systematic search, 11 studies were included for the final analysis, of which nine used space maintainers (a lower lingual arch) and two used space regainers (one lip bumper and one transpalatal arch) with contradicting results. Four of the former and one of the latter devices showed a significant increase in arch length. Out of the 11 articles, one was found to be of critical risk, two of serious risk and eight of moderate risk of bias. CONCLUSIONS: There is very low evidence to suggest that space maintainers and regainers are effective in preserving arch length and preventing mild to moderate crowding in children during the mixed dentition stage at the expense of lower incisor proclination. However, considering the low evidence provided by this systematic review, high-quality studies are needed.

Comparison of fit accuracy between conventional and CAD/CAM-fabricated band-loop space maintainers.

AIM: The aim of this in vitro study was to evaluate the band fit of metallic band-loop space maintainers fabricated by conventional and 3D printing technologies for clinical applications. DESIGN: Sixteen digital intraoral impressions were selected, and resin models were printed with a 3D printer. Forty band-loop space maintainers were fabricated (20 each for both the conventional and digital groups). To evaluate the band fit of conventional and CAD/CAM-fabricated space maintainers, cement space was visualized with low-viscosity condensation silicone material on resin models. Digital evaluation was carried out using dual scan method by superimposing two scans of resin models covered with or without a silicone layer on the abutment tooth. The mean quadratic deviation (root mean square, RMS) was calculated. The RMS values between the groups were evaluated with Student's t test. Statistical significance was set at p < .05. RESULTS: No statistical significance was found between the conventional and digital groups (p = .56). CONCLUSIONS: Within the limitations of this study, the band fit of conventional and CAD/CAM-fabricated space maintainers had no difference. Future research into CAD/CAM-fabricated appliances from different perspectives such as fracture strength and patient comfort is warranted.

Distal guide as a substitute for distal shoe space maintainer: a case series study.

Early loss of the primary second molar (DSM) before the eruption of the permanent first molar (PFM) may result in its mesial drift during the eruption. Traditionally, a distal shoe space maintainer is used in this situation to control the path of eruption and preserve the space. However, considering its disadvantages, an alternative appliance needs to be developed for guiding the unerupted PFM. The purpose of this article is to represent an innovative design for preserving space after the early loss of the DSM, describe the fabrication process, and present some data on the successful results of using the appliance in five cases.

A Four-Year Follow-Up Case Report of Hypomineralized Primary Second Molars Rehabilitated with Stainless Steel Crowns.

Hypomineralized primary second molars (HPSM) are characterized by enamel opacities accompanied by hypersensitivity and atypical caries lesion, on one to four primary second molars. The correct treatment and follow-ups of those teeth have an important impact on a correct eruption of the first permanent molars and future occlusion. Hence, this report aims to describes a case of a severe HPSM in all second molars of a four-year-old girl and subsequent four-year follow-ups. The rehabilitation involved the placement of four stainless steel crowns on all four second primary molars under general anesthesia. Concerning the available literature and the case severity of HPSM, the treatment approach proposed for the case provided good functional outcome.

Rapid Palatal Expansion and Utilization of E-space in Mixed Dentition: Mechanics that Helps in the Corrective Orthodontic Treatment.

AIM AND OBJECTIVE: The objective of this article was to report two clinical cases, showing the benefits of interceptive treatment using rapid palatal expansion (RPE) and the preservation of E-space. BACKGROUND: It is important to follow-up child throughout its development to detect irregularities in their occlusion and to avoid or attenuate orthodontic treatments in the future. Posterior crossbite and transverse maxillary deficiency can easily be corrected by RPE that enhances the width of the maxilla and promotes a gain of space in the arch. Another way to gain space in the arch is by using the E-space, which is the difference between the mesiodistal distance of the second primary molar in relation to the second premolar. This additional space can be used to resolve negative, mild, or moderate crowding. CASE DESCRIPTIONS: Two clinical cases that presented malocclusions due to lack of space and maxillary deficiency, along with clinical technic of how the RPE and E-space can be used to bring those patients back to normality. CONCLUSION: We concluded that with a right diagnosis, correct interceptive timing, and using what growth provides, the development can be reestablished. CLINICAL SIGNIFICANCE: The clinical importance of this report is that RPE and E-space are efficient interceptive orthodontic treatments to correct skeletal posterior crossbite (SPC) and gain space in dental arches. HOW TO CITE THIS ARTICLE: Lopes BKB, Scheicher GV, Matsumoto MAN, et al. Rapid Palatal Expansion and Utilization of E-space in Mixed Dentition: Mechanics that Helps in the Corrective Orthodontic Treatment. Int J Clin Pediatr Dent 2021;14(1):133-139.

Proposal of use of the autotransplantation of the third molar as space maintainer in growing patients: a review of literature and a clinical case.

The review of literature shows that 48,22% of the autotranspated teeth were orthodontically treated. A 13-year-old male patient presented a destructive decay in the element 3.6, which was underoccluded. To maintain the arch space and the quantity of bone necessary for a potential implant, it was decided to perform an autotransplantation of the impacted element 3.8. Tooth autotransplantation is a valid and durable alternative to the prosthetic and the implant solutions with high success rate.

Accuracy of Model Estimation versus Tanaka and Johnston Arch Length Analysis.

OBJECTIVES: This study examines how accurate pediatric dentists are at estimating dental arch lengths by comparing their model estimations (guesstimating the arch length without measuring) to the Tanaka and Johnston mixed dentition arch length analysis. STUDY DESIGN: This study consisted of two parts, a survey of practitioners and a model estimating and measuring component. The survey was designed and given to 44 pediatric dentists to determine how many were practicing orthodontics and using arch length analyses routinely. Then 18 pediatric dentists and 13 pediatric dental residents examined 20 sets of mixed dentition models and estimated how much space was available. These estimations were compared to the calculated gold standard, the Tanaka and Johnston arch length analysis of the same models. RESULTS AND CONCLUSIONS: More than half of the dentists surveyed that practice comprehensive orthodontics use arch length estimates. Pediatric dentists and pediatric dental residents are just as good as each other at estimating arch length. Pediatric dentists and pediatric dental residents underestimated arch length by -3.6 and -3.1 mm, respectively. More research needs to be done to determine if model estimation is a clinically acceptable way to judge arch length.

Short-term efficacy of vacuum-formed maintainer for deciduous second molar space maintenance in the mixed dentition: A single-centre, randomized controlled clinical trial.

OBJECTIVE: To compare the efficacy of vacuum-formed and banded space maintainers for deciduous second molar space maintenance during the mixed dentition. SETTING AND SAMPLE POPULATION: The study sample comprised thirty children in the mixed dentition (age range, 5.9 to 9.8 years) with early loss of at least one deciduous second molar. METHODS: This was a parallel-group, randomized, active-controlled clinical trial. Patients were randomly allocated to space maintenance performed with vacuum-formed or banded space maintainers with a 1:1 allocation ratio. The main outcome was any change in mesiodistal width of the extraction space. Secondary outcomes included the lingual rolling or axial rotation of the permanent first molar adjacent to the extraction site and extrusion of the antagonist tooth. Dental casts were obtained before appliance installation (T0), after 3 months (T1) and after 6 months (T2). Digital dental casts were measured using Dolphin 3D software. Chi-square, t test or Mann-Whitney and ANOVA or Friedman test were used for intra- and intergroup comparisons (P < .05). RESULTS: Baseline characteristics were similar between groups except for chronological age. Statistically, but not clinically significant space loss (mean, 0.32 mm; SD, ± 0.39) occurred with the vacuum-formed space maintainer only at the first trimester (T0-T1). Lingual rolling and axial rotation of the first permanent molar were not significant, as well as extrusion of the antagonist tooth. CONCLUSIONS: The results of this study suggested that both tested devices were effective in maintaining space after early extraction of the deciduous second molar over a period of 6 months.

Maximum equivalent stress induced and the displacement of the developing permanent first molars after the premature loss of primary second molars: A finite element analysis.

BACKGROUND: The use of a space maintainer during the deciduous dentition period at a proper time can prevent the consequences of the loss of the arch length in the future. There is controversy over the use of space maintainers. OBJECTIVES: The aim of this study was to evaluate the magnitude of stresses exerted on immature permanent molar teeth, and the extent of displacement of these teeth when the adjacent teeth are missing, but after placing a space maintainer. Studies carried out to date have used clinical measurements, e.g., X-rays and dental casts. MATERIAL AND METHODS: The finite element model (FEM) was used for modeling the maxillary and mandibular teeth and the bone structure. A space maintainer (band and loop) was also designed for modeling. Force was applied and a finite element analysis (FEA) was carried out in 6 states in the maxilla and in the mandible to evaluate the distribution of stresses and the amount of displacement of immature permanent first molar teeth in the presence or absence of deciduous second molar teeth and a space maintainer. RESULTS: During mastication, when the deciduous second molar tooth was absent, the maximum stress was transferred to incomplete roots. When there was a space maintainer, stress was transferred to the space maintainer itself and to the distal side of the deciduous first molar tooth. The displacement of permanent first molar teeth was minimal in the presence of all teeth; in the absence of the deciduous second molar tooth, this displacement increased 4-5-fold, which decreased again almost to the level of the 1st/4th state (intact arch) in the presence of the space maintainer. CONCLUSIONS: The results showed the importance of the use of space maintainers, as they significantly decrease the momentary displacement of the teeth as well as the stress exerted on the developing permanent first molar teeth.

A Modified Removable Space Maintainer for Compromised Dentition of Children: A Case Series.

Despite the attempt in prevention, premature loss of primary teeth remains to be a frequent problem in pediatric dentistry, resulting in disturbance of arch integrity and unfavorably affecting the alignment of permanent successors. Space maintainers (SMs) are distinctive appliances used for maintaining space created due to premature loss of primary teeth. But at times the dentition of children is so compromised that it prevents the use of a conventional SM. Introduced in this article is an innovative modified removable functional SM that offers several benefits over the traditional appliance. It is a straightforward and rapid method to fabricate but also omits band adaptation in uncooperative children and helps restore the functional harmony. HOW TO CITE THIS ARTICLE: Agarwal T, Agarwal N. A Modified Removable Space Maintainer for Compromised Dentition of Children: A Case Series. Int J Clin Pediatr Dent 2020;13(6):722-724.

Clinical Evaluation of Ghana Shyams TEFF (Telescopically Expanding Fixed Functional) Space Maintainer Versus Conventional Band and Loop Space Maintainer

Abstract Objective: To compare the clinical efficacy of Ghana Shyam's TEFF space maintainer with band and loop space maintainer. Material and Methods: This split-mouth randomized clinical trial was conducted on 20 children (7-9 years), requiring bilateral/contralateral space maintenance therapy. After consent, all the selected children received both space maintainers and were followed up periodically every six months up to two years for clinical assessment according to the evaluation protocol. Instructions and motivation were given to the children. OHI (S) index was recorded before cementation of appliances. The following aspects were analyzed: 1) efficiency and function; 2) dislodgement due to cement loss; 3) breakage at soldered parts; 4) carious or gingival inflammation affecting abutment teeth; 5) distortion of band; 6) being embedded in gingival tissues / gingival slopping; and 7) initial and final S-OHIS scores. Statistical analysis was done using Fisher exact test for survival time and Chi-square test for chewing efficiency. Results: At 24th-month follow-up, 14 Ghana Shyam's TEFF space maintainers and 16 band and loop space maintainers were found to be intact. Conclusion: As both space maintainers demonstrated similar mean survival time Ghana Shyam's TEFF space maintainer with the added advantage of being functional can be recommended as an effective alternative to band and loop in premature loss of primary molar clinical situations.

Comparison of the longevity of prefabricated and conventional band and loops in children's primary teeth.

BACKGROUND: Prefabricated band and loops require only one appointment, are quickly placed in a session, and do not require laboratory work; thus, they need less time and cost. The aim of this study was to evaluate the survival rate of prefabricated band and loops in space maintenance of primary teeth and compare them with conventional band and loops. MATERIALS AND METHODS: In this prospective clinical trial study 4-9-year-old patients, who met the requirements of the present study, were divided into two groups. The first group conventional band and loops and the second group prefabricated band and loops were placed. The patients were evaluated for cement dissolving. Failure of soldering (SF), breakdown, and deformation of each component of the band and loops, survival rate, and gingival health at the 1st, 3rd, 6th, and 9th-month Wilcoxon test, Fisher's exact test, Mann-Whitney test, Friedman test, and Kaplan-Meier test. Was used The level of statistical significance was set at P ≤ 0.05. RESULTS: The two groups were not significantly different at the 1st, 3rd, 6th, and 9th-month recalls in cement solution, SF, breakdown, and deformation of each component of the band and loops. The survival rate of the conventional and prefabricated band and loops was 92% in the 9 months, and no significant difference was witnessed in survival rates between the two groups. The prevalence of gingivitis in prefabricated band and loops and conventional band and loops in the 9th month was statistically insignificant (P = 0.03). CONCLUSION: There is a similar success rate for the conventional and prefabricated band and loops.

[Space maintenance for the premature loss of the second primary molar].

Space reduction after the premature loss of the second primary molars is one of the important factors affecting the occurrence of malocclusion, often increasing the demand for orthodontic treatment. It has great significance to select and apply appropriate appliances to maintainthe space soon after the premature loss of the second primary molars. The space should be maintained until the adjacent teeth and the successors erupt successfully. This review summarizes the selection and clinical application of the space maintainer for the premature loss of the second primary molars in different periods, to improve dentists' awareness of the importance of space maintainers and to provide advises for clinical choices.

Efficacy of Maximun Anchoring Using Transpalanance and Double ATP in Cases Requiring First Superior Premolar Extractions: A Comparative Analysis / Eficacia del anclaje máximo usando transpalanance y doble ATP en casos de extracciones de primeros premolares superiores: Análisis Comparativo

ABSTRACT Introduction: Space maintainers play an important role in orthodontic treatments involving premolar extractions, especially in cases with bad occlusion and marked crowding. The orthodontist must know several options of anchoring and choose the best method that would fulfill the treatment objectives for that patient. Objective: To compare the effects of maximum anchors like the double transpalatal arch (double ATP) and the transpalatal arch and Nance button combination (transpalanance) as space maintainers during cuspids retraction in patients undergoing upper bicuspid extractions. Methods: A universe of 100 patients, aged 14-25 years, was selected from among the patients presenting to the Orthodontics Specialty Clinic of the posgraduate School Dr. José Apolo Pineda, Pilot School of Dentistry, University of Guayaquil during the years of 2017 and 2018. Totally, 26 patients were recruited, of whom 13 were placed on transpalanance and the other 13 on double ATP, prior to the extraction of their first upper bicuspid. Post-extraction spaces were measured and compared with post-retraction spaces of upper cuspids. Results: With an average of 4-5 mm, transpalanance maintained the greatest amount of space at the end of canine retraction. It is expected that the results obtained in this study will be useful to orthodontists, providing them with information regarding the most effective space maintainers for treatments with extractions. Conclusion: The maximum anchor that showed the greatest efficacy was transpalanance since it maintained a greater amount of space during its time of use.

RESUMEN Los mantenedores de espacio desempeñan un papel importante en los tratamientos de ortodoncia que incluyen extracciones premolares, especialmente en casos de oclusión grave y aglomeración marcada. El ortodoncista debe conocer varias opciones de anclaje y elegir el mejor método que cumpla con los objetivos de tratamiento para ese paciente. Objetivo: comparar los efectos de los anclajes máximos como el arco transpalatino doble (ATP doble) y el arco transpalatino y la combinación del botón de Nance (transpalanance) como mantenedores de espacio durante la retracción de los cúspides en pacientes sometidos a extracciones de premolares superiores. Métodos: Se seleccionó un universo de 100 pacientes, de 14 a 25 años, entre los pacientes que acudieron a la Clínica de Ortodoncia de la Escuela de Posgrado de la Facultad Piloto de Odontología, Universidad de Guayaquil durante los años de 2017 y 2018. En total, se reclutaron 26 pacientes, de los cuales 13 fueron colocados en transpalanance y los otros 13 en doble ATP, antes de la extracción de su primer premolar superior. Los espacios posteriores a la extracción se midieron y compararon con los espacios posteriores a la retracción de los caninos superiores. Resultados: Con un promedio de 4 a 5 mm, el transpalanance mantuvo la mayor cantidad de espacio al final de la retracción de caninos. Se espera que los resultados obtenidos en este estudio sean útiles para los ortodoncistas, proporcionándoles información sobre los mantenedores de espacio más efectivos para los tratamientos con extracciones. Conclusión: el ancla máxima que mostró la mayor eficacia fue la transpalanidad, ya que mantuvo una mayor cantidad de espacio durante su tiempo de uso.

Aesthetic-Functional Fixed Appliance as Treatment of Premature Loss of primary Anterior Teeth / Mantenedor de Espaço Fixo Estético-Funcional como Tratamento para Perda Precoce de Dentes Decíduos Anteriores

The early loss of anterior primary teeth is frequent in the pediatric dentistry clinic and it is associated with extensive caries or dental trauma. The purpose of this study was to report two cases of aesthetic-functional rehabilitation due to early loss of anterior primary teeth, with the aid of fixed space maintainers of the tube-bar type. In the first case, a 4-year-old female child referred for dental treatment is reported. During clinical examination, several restorations in the posterior teeth and absent upper anterior teeth were observed. The treatment plan consisted of installing a tube-bar type upper fixed space maintainer, considering the ease of installation and adaptation for young children. The second case reports a 5-year-old male patient with the main complaint of dental caries. Clinical examination revealed extensive coronary destruction in the upper central incisors, as well as in the posterior teeth that presented carious lesions in several teeth. For the case planning, it was determined the need for the posterior teeth restorations and the exodontia of the anterior dental remnants. After oral rehabilitation, an aesthetic-functional space maintainer of the tube-bar type was made and installed. In both cases, prosthetic rehabilitation was fundamental to maintain the space until the eruption of the permanent successors, avoiding future damages, as well as to restore the children's self-esteem and introversion behavior. (AU)

perda precoce dos dentes decíduos anteriores é frequente na clínica odontopediátrica e está associada a processos de cáries extensas ou traumas dentários. O objetivo do presente estudo foi relatar dois casos clínicos de reabilitação estético-funcional após perda precoce de dentes decíduos anteriores, com auxílio de mantenedores de espaço fixo do tipo tubo-barra. O primeiro caso refere-se a uma criança do sexo feminino, quatro anos de idade, encaminhada para atendimento odontológico. Durante exame clínico, observou-se restaurações nos dentes posteriores e ausência dos dentes anteriores superiores. O plano de tratamento consistiu na instalação de um mantenedor de espaço fixo superior do tipo tubo-barra, levando em consideração a facilidade de instalação e adaptação para crianças com pouca idade. O segundo caso reporta um paciente de sexo masculino, cinco anos de idade, tendo como queixa principal a presença de cáries dentárias. Ao exame clínico, foi notado extensas destruições coronárias nos incisivos centrais superiores, assim como nos dentes posteriores. Para o planejamento do caso, determinou-se a necessidade de restaurações dos dentes posteriores e as exodontia dos remanescentes dentários anteriores. Após adequação do meio bucal foi confeccionado e instalado um mantenedor de espaço estético-funcional do tipo tubo-barra. Em ambos os casos, a reabilitação protética foi fundamental para a manutenção do espaço até a irrupção dos sucessores permanentes, evitando prejuízos futuros, devolvendo a autoestima e a mudança do comportamento de introversão das crianças.(AU)