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91 comments:
In order to assess the amount of time until eruption you can use the general rule of 4-6 months for each mm of bone OR that 3/4 of the root will be developed at the time of eruption.
Liz Miltner #150
Natalie Nguyen #159:
Yamamoto et al. found that malalignment of posterior teeth is mostly affected by lost of molars than primary canines (whose loss affect crowding of anterior teeth). Prioritize mandibular space maintenance over maxillary. Finally, the best space maintainer is the tooth itself.
If you need to create a space maintainer for maintenance of space in the artch, first recommendation is to use lingual holding arches and the second recommendation is the bands/loops method.
Neilesh Patel
#165
If you extract a tooth too early, bone may fill the healing extraction socket and can lead to delayed eruption of the erupting permanent tooth.
Looking at the radiograph you can determine whether or not a space maintainer will be needed after extraction of a primary tooth by measuring the amount of bone above the erupting permanent tooth. 1mm bone = 5-6 months of eruption time.
Bilaterally missing canines leads to uprighting of the incisors, which means closing of spaces.
steph morphis #154
Magical minute
A missing primary canine tends to affect only the anterior teeth, not the posteriors.
The best space maintainer is the natural tooth itself.
#176
Prioritize the mandibular spaces first versus the maxillary. Early tooth lost in children are usually due to infection (caries) and trauma (avulsion).
-Shelton Chow #111
Place priority on space maintenace of mandibular molars due to their mesial eruption path.
Early loss of primary incisors and canines do not have an impact on posterios occlusion, it only affect the alignment of anterior teeth.
Heidi # 526
When making a mandibular lingual holding arch, make sure to allow space for erupting incisors on the lingual side.
Orly Hendizadeh, #134
Early loss of primary canines, causes uprighting of the Incisors, followed by lingual or palatal inclination.
Prioritize Mand. space maintenance over Max., due to direction of eruption of mand 1rst permanent molar with more loss of space.
Dilshad Abtin #524
I learned that the distal shoe is never really used anymore, because you have to cut the gingiva, which forms a communication with the bone; not good for infection, also on lower lingual arches, make sure cusps are erupting buccally as to not catch on the bar and impede eruption
Jake Cragun #117
Kids who require greater number of extractions are very likely to need ortho tx. However, not all pts can afford ortho tx.
Tina Duong 125
Space maintaining appliance should be used for posterior teeth. Fixed or removable. Lower lingual holding arch (whether we could take impression) and banded loop, then removable (whether pt will wear it).
Eric Cheung #110
i learned that space maintainance is more critical for md and posterior teeth.
Catherine Do #122
Lower lingual holding arches are the most ideal treatment option in order to maintain space, especially in the posterior area.
-Carol Kim (138)
For Fixed Unilateral Space Maintainer: Consider Band and Loop
For Fixed Bilateral Space Maintainer:Consider using lower lingual holding arch.
Karen Li #146
I learned today the importance of space maintenance in children. Many children of low income families will not have orthodontic treatment. It is especially important for them that we do not extract primary teeth unless it is necessary. When we do, a space maintainer appliance will allow for the proper eruption of a permanent tooth.
Premature loss of molar leads to problems with posterior alignment whereas premature loss of anterior teeth are mainly an 'esthetic concern' for parents. Watch for opposing arch supraeruption though.
Raquel Ulma 188
Fixed distal shoe is not commonly used and allows communication of the oral environment to bone. LLHA, band & loop, and removable space maintainers are useful to prevent closing of spaces due to premature loss of primary teeth.
Austin Tung 187
Prioritize mandibular space maintanence over maxillary. Part of the criteria for placing a space maintainer is the eruption status of the permanent tooth. You can judge this by the height of bone over it (1mm = ~5-6 mos) and by the maturation of the root (usually 3/4 complete at eruption).
Chris Claus 113
When tx planned to provide space maintainer, think of lingual holding arch first, then band and loop. Removable appliance should come last.
Sonia Lee 145
Lossing posterior teeth has more effects on occlusion than lossing anterior teeth. rita chen 109
Loosing canine, anterior teeth will become upright. Mand teeth erupt in a mesial curve. Max teeth erupt in a distal curve. Eruption through 1mm bone takes 5-6 months.
Jing Lee #144
To maintain the second primary molar space before the eruption of first permanent molar, distal shoe maintainer is not widely used anymore. Instead, a removable appliance with acrylic block replacing missing second primary molar is an better option.
Lei Zeng, #535
When the patient is missing a primary 1st molar, it’s okay to use a band & loop space maintainer until the permanent 1st molar erupts. At that time, one should switch to a lower lingual holding arch, because when the mandibular canine exfoliates, the band & loop is pointless. Additionally, the band & loop space maintainer works better for the maxilla than the mandible.
Sean Young #192
The best space maintainer is the natural tooth. It takes about 4-5 months for a tooth to move through 1mm of bone.
Also, in the mandible, it is best to use a LLHA instead of a band and loop.
Regina Espinoza #126
For spac maintaining, first think about lower lingual holding arch, if there is no permanant first molar to retain lower lingual arch, band and loop is second choice.
Tiffany Hsu #529
Jonathan Do #121
Early loss of the primary canines can result in anterior crowding while early loss of the primary posteriors(1st or 2nd molars) can result in misalignment of the posteriors. Early loss of the primary canines will not effect the posteriors.
When planning to preserve space in the pediatric patient, prioritize mandibular space maintenance over maxillary space maintenance. First consider a lower lingual holding arc, then the band and loop, and finally a removable appliance.
Christine Chung #112
After extracting a tooth, the first consideration is to evaluate the need of space maintener, also it's important to check the permanent tooth root development in the x-ray .
Claudia Rodriguez #531
A natural tooth makes the best space maintainer, and if there is no need to extract, it is probably best to leave it there.
I liked the concept that we should think twice before extracting teeth in poor children, taking into consideration their abilty to afford braces or not.
Marc Thomas
#182
Prior to extracting a primary tooth, it is important to consider the time it will take for the permanent tooth to replace it, because the primary tooth serves as a great space maintainer. In addition, extracting a primary tooth too early may interfere with the subsequent eruption of a permanent tooth due to bone deposition that may result in that area
Bozhena Fisher #128
I learned that losting a primary tooth prematurely can cause untoward results if the socket fills in with bone. The succedaneous tooth might be delayed in eruption or altered in its eruption path since it will have to push through that bone.
Will Traynor #186
My magic minute from lecture this week was learning about the importance of space maintenance for the posterior teeth. It is more important to maintain space in the posterior part of the jaw than the anterior because it effects the occlusion more.
Ryan Plewe
#168
Michelle Duong #123
Reasons to extract primary teeth include: severe infection, unrestorable teeth, trauma, and space maintenance. The posterior is more important for space maintenance.
When considering space maintainers - think ligual holding arch first, before band and loop.
Take care of mandibular spaces first versus the maxillary.
Alina Tiraspolskaya (#183)
If the primary canine is lost prematurely, there is no space loss effect on the posterior. Eruption occurs at a rate of about 1mm/5-6months.
Shannon Lazarian
#133
Prioritize mandibular space maintenance over maxillary space maintenance. Know about the distal shoe, but also know that it is never used.
Joanne Kim #140
It is important to account for erupting permanent teeth in designing fixed or removable space maintainers.
Shelby Padua #166
There will be significant posterior malallignment if a decidious molar is loss but no significant relationship if a canine is lost. You can use a fixed or removable space maintainers depending on the pt. A tooth takes 4-5 mos to move through 1mm of bone.
Jun Flores #130
space maintenace of mandibular molars has priority over maxillary.
Soheil Yashari #191
A good rule of thumb for estimating the amount of time before a permanent tooth erupts is that it takes a permanent tooth about 5-6 months to move through 1 mm of bone.
Paul Hoang #135
Mandibular spaces should be adjusted prior to maxillary. Also, the best space maintainer would be a natural tooth.
Ernest Lai #141
The malalignment of posterior teeth is significantly affected by the extraction of molars, but not by the premature loss of canines. Crowding of the anterior teeth, however, is directly affected by the premature loss of primary canines.
Kevin Omoto
#163
Any time a primary tooth is extracted, you have consider how much time is left before the permanent tooth erupts in its place; every one mm of bone above the permanent tooth will take 4-5 months, so this helps approximate the amount of time space maintenance is needed and determine the type of appliance used
-Jeanne Wong, #195
Using space maintainers for posterior teeth are slightly more significan than for anterior teeth since edentulism in the posteriors has a greater effect on future spacing problems than anteriors.
Sean Nguyen #160
Maintaining space in mandibular arch is more important than maxillary. Premature loss of primary mand canines affects the alignment of mand ant teeth.
Stacy Yu #193
The best space maintainer is tooth itself.If you need space maintenance due to loss of a tooth the first recommendation would be lingual holding arches and the second would be ban and loop space maintainer.
Amandeep Iqbal.
# 527.
When deciding whether space maintenance is necessary, you can assume approximately 6 months until eruption per mm of bone over a tooth bud.
[Colby Smith #178]
When tooth extracted early, bone may fill the healing extraction socket and can lead to delayed eruption of permanent tooth.
Jan Slapnicka
#533
That anterior teeth, unlike posterior teeth, are not very critical for space maintenance, and that the major concern regarding anterior teeth is aesthetics.
The last comment about the importance of posterior teeth for space maintenance and that anteriors are not very important for space maintenance but are critical for aesthetics was posted by me.
Steve Kim
#528
If there are multiple missing posterior primary teeth, the type of space mainter is dependent on whether permanent incisors are present. If they are not erupted, in the maxilla, a Nance appliance can be used, if they are erupted, then a lingual arch, Nance appliance, or removal partial denture can be used.
Matthew Moadel #151
Majic moment:If primary 1st molar is lost use a band & loop space maintainer,if second primary molars are lost and permanent 1st molar is not present fixed distal shoe can be used.
poonam rai
#530
I learned that the best way to maintain space is with the existing primary tooth. Early extraction may lead to bone fill of socket and subsequent delayed eruption of permanent tooth.
Robert Busan #107
In the case of an unrestorable primary tooth, extraction may be needed before its permanent successor is ready to erupt. A complication arises if bone fills the extraction socket above the developing tooth. The "buried" permanent tooth will have an increased chance of being impacted.
J. Oka #162
Azadeh Ahmadi-Ardakani
student 101
Loss of Canine teeth will only affect the anterior and not the posterior teeth
early loss of molars will cause space and supereruption problems
Premature loss of deciduous teeth can result in malocclusion and increase the need for orthodontic treatment. Premature loss of decidous molars increases the likelihood of malalignment of permanent posterior teeth whereas premature loss of primary canines can result in crowding of permanent anterior teeth.
Richard Duong #124
Loss of teeth in the posterior can affect the childs occlusion. Time until eruption can be predicted by the amount of bone (1mm=6mo.)
Alex Molayem 152
Loss of teeth in the posterior can affect the childs occlusion. Time until eruption can be predicted by the amount of bone (1mm=6mo.)
Alex Molayem 152
A majority of early loss of primary teeth is due to extensive caries or trauma; the most significant tooth loss, in regards to importance of space maintenance, occurs in the mandible and in the posterior.
Cristen Dismuke #118
During diagnosis and treatment planning, prioritize mandibular space maintenance before maxillary space loss. Mandibular spaces close faster.
Jared Lee
#143
Mandibular teeth erupt in a mesial curve while maxillary teeth erupt in a distal curve. A natural tooth provides the best source of space maintenance.
Farshid Siami #177
Losing primary anterior teeth pre-maturely is more of an esthetic problem, whereas losing posterior teeth might require space maintenance.
Sanam Soroudi
#180
When extracting primary teeth, be mindful of the effect it will have on the permanent dentition. Consider the expected time until permanent tooth eruption and expected time until loss of abutment teeth in designing space maintainers. Posterior primary tooth loss has a greater tendancy to affect spacing than anterior tooth loss.
Diana Craft 115
You should prioritize mandibular space maintenance over maxillary space maintenance b/c of the eruption pattern, and posterior space maintenance is more important than anterior space maintenance.
Morris Poole #169
When deciding between a fixed or removable space maintainer, consider your ability to place a band and take an impression plus consider the expected compliance of the patient.
Emmy Le #142
If you decide to use mandibular lingual arches plan for lingually erupting molars. If not the lingual arch can disrupt normal eruption.
Dave Tajima
#181
The choice for space maintanence if the primary molars are lost in the mandibular arches is the lingual arch, which if not designed correctly can cause malalignment of the erupting permanent teeth.
Asha Sethu Madhavan
#532
Prior to eruption of 1-st permanent molar, every effort should be made to save 2nd primary molar, if it's not possible to save it then a removable acrylic appliance should be used to prevent unfavorable eruption of a permanent molar.
Edvin, #100
Fixed space maintainers are preferred to removable space maintainers. Posterior tooth loss requires space maintenance, whereas anterior tooth loss does not necessarily require space maintenance
Daniel Nelson #157
Best space maintainer is the actual tooth if it can be kept. Otherwise, space maintenace for posterior teeth is more crucial than space maintenance for anterior teeth.
Nick Quach #170
It's important not to extract and try to preserve the 1st primary molars b/c it will cause the 2nd molar to shift mesially and the subsequently cause crowding. Also, if extracted early there might be alveolar bone forming and delay the eruption of the 1st permenant pre-molar.
Sanaz Hamzehpour #132
It's important to know that a tooth can move through 1mm of bone in 4-6 months because this can determine whether to use a space maintainer or not.
Josh Cardwell #108
I learned that it takes approx 5-6 months of eruption time for each mm of bone that the tooth travels through.
Also, the space that is created by a missing molar is more important to maintain than the space created by a missing anterior tooth, so we have to prioritize in that order.
Jonathan Miller #149
The very best space maintainer is the natural tooth. Priority should be given to maintaining space in the mandibular arch. Distal arches can be problemmatic by creating an open communication with the bone which can lead to infections.
Jared Martin #147
Pedram Sooferi
179
Natural teeth are the best space maintainers and comparing to the maxillary, mandibular space maintainers are more important
Posterior teeth a not affected by missing primary canines. It has to more with missing posterior teeth, which occurs primarily by caries and trauma. Also, prioritize the spacing maintenance of mandible teeth than the maxillary.
Paredes #164
Space maintenance should be first addressed in the mandibular posterior dentition. Other than appliances such as the lingual holding arch, the best space maintainer is a natural tooth.
#184
Most magical minute:
The most important thing that I learned is that if a tooth is lost too early then the socket could be filled with bone and make it harder for the permenant tooth to erupt. To determine how long it will take the tooth to erupt, you can look at the radiograph and assume that it will take about 5 months for each 1mm of bone.
Paul Field #127
1. You can aproximate the eruption of a permanent tooth by analyzing the radiograph: 1mm of bone for 5-6 months.
2. When you make a lingual holding bar make sure it is away from the posterior teeth in order to let the permanent teeth to erupt.
Cornel Crasnean #525
I learned that space maintenance is a priority for mandibular teeth, as well as for more posterior teeth.
Sujain Dissanayake #119
Groper appliance is a mesh bonding base soldered to lingual arch; and plastic denture tooth adapted and bonded to mesh base.
Naomi Nguyen
158
Early loss of a primary maxillary cuspid will result in a midline shift to the side of the lost one.
Broc Mushet
#156
I learned that the distal shoe is not actually used often, and can cause an infection by an open communication to bone. Also I learned that you should prioritize mandibular and posterior space maintinance.
Cynthia Morford #153
Space maintenance is more importand in the mand. arch. a lingual holding arch is prefered. And when doing multiple extractions, consider ortho treatment.
-Harry Virk #189
Space maintaining appliance should be used for posterior teeth
Mihir Shah
175
When making space maintainers, one must prioritize the mandibular arch over the maxillary arch, and space maintenance is more important for posterior teeth. Also, when tx planning, LLHA is preferred over band and loop.
Enayat Astani
#308
The best space maintainer is the tooth that was supposed to be there.
Varo Boyajyan #106
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