Early Loss of Deciduous Teeth Flashcards
Importance of primary dentition
(2)
- The primary dentition plays a very important role in the child’s
growth and development, not only in terms of speech,
chewing, appearance and the prevention of bad habits but
also in the guidance and eruption of permanent teeth. - Exfoliation of primary teeth and eruption of permanent teeth
is a normal physiological process.
Reasons for Loss of Primary
Teeth
(4)
- Premature loss of primary teeth
- Proximal carious lesions
- Trauma
- Orthodontics reasons. (Crowding,
Malalignment,…)
Consequences
It may lead to:
(8)
- Mesial migration of teeth
- Malocclusion in permanent
dentition - Crowding
- Impaction of permanent teeth
- Supraeruption of opposing teeth
- Changing/redirecting the path of
eruption - Loss of the arch length
- Decreasing arch-perimeter
What can we do?
* The best way to avoid these problems is to
preserve the primary
teeth in the arch till their normal time of exfoliation is attained.
Primary teeth serve as the best
space maintainers for the
permanent dentition
- If premature extraction or loss of tooth is unavoidable (for any
reason)the safest option to maintain arch space is by placing
a … - The SM appliance maintains the …
“Space Maintainer”.
extraction space for
settlement of the successor permanent tooth.
If premature extraction or loss of tooth is unavoidable
due to extensive caries or other reasons, the safest option
to maintain arch space is by placing a —
Space Maintainer.
Space maintenance is appropriate
only when:
(3)
- All unerupted teeth are at the normal stage of
development. - Adequate space is available.
- All unerupted teeth are present.
Important numbers to
remember
* If a permanent successor will erupt within – months, a space
maintainer is unnecessary.
* If more than – of its root has
formed, SM is unnecessary.
* We expect to see the tooth in the mouth when — of the
root is developed.
6
one-half to two-thirds (1/2 to 2/3)
3/4
Special
considerations:
* In some situations, space maintenance alone is
inadequate or inappropriate, and the other treatment
approaches will be needed.
* These situations could be :
(5)
- Space loss. (not enough space for the permanent tooth)
- Missing permanent tooth.
- Severe skeletal discrepancy.
- Severe crowding.
- Severe spacing.
pace Maintainers
* Fixed
(2)
* Removable
(2)
- Unilateral
- Bilateral
- Unilateral
- Bilateral
Fixed Space Maintainer
* Four common fixed appliances generally used to
maintain space in the primary dentition are:
(4)
- Band & Loop. (Crown & Loop)
- Lower Lingual Holding Arch. (LLHA)
- Nance.
- Distal Shoe
B&L vs LLHA
(4)
- Before eruption of the permanent incisors, if a single primary
molar has been lost bilaterally, a pair of band & loop space
maintainers is recommended. - This is advisable because the permanent incisor tooth buds are
lingual to the primary incisors and often erupt lingually. - The bilateral band and loops enable the permanent incisors to
erupt without interference from a lingual wire. - The survival of band and loops is not impressive. It has been
judged to be approximately 18 months with cement failure
cited as the most frequent problem. (routine recall visits)
Space Regaining
(2)
- If the space maintainer is not used on the premature loss of
deciduous second molar, the permanent first molar may tip or
move mesially. - The process of re-gaining the space lost by drifting of adjacent
teeth following premature loss of deciduous teeth/tooth is the
treatment of choice.
Space Regainer
(2)
- The Space Regainer is similar appliance to the Space
Maintainer but is spring loaded. - This appliance is used to regain space when the first
molar has already begun to drift into the space left
by the primary molar.
