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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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On intraoral examination it was found that spaace upper central incisors were fractured Figure 1. 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.

Unsupervised Distal Shoe Appliance: A Case Report | OMICS International

Patient and the parents were completely unaware of the problem caused by the appliance on the eruption of succedaneous second premolar. Apart from the eruption disturbance, other abnormalities that may rise from periapical lesions mmaintainer with primary dentition include enamel hypoplasia, Turners Hypoplasia ; displacement and rotation of the tooth, partial or complete stoppage of root mainainer of the succeeding permanent tooth.

The space maintainer was well-accepted by the child and his parents and was optimistic for the future of his dentition. One such appliance was presented by Willett called distal shoe space maintainer with distal extension which goes intra-gingivally to guide the eruption of permanent first molar [ 10 ]. Bilateral design of distal shoe was planned for unilateral loss of dsital molars. Photograph after eruption of premolars.

The modified distal shoe appliance is time efficient, more stable, better accepted by the ahoe and meets all the criteria for proper space maintainer. Open in a separate window.

This appliance should be changed with band and loop space maintainer after eruption of permanent first molar to avoid any adverse effect on the second premolar, as seen in this case. Intraoral periapical radiograph showing modified distal shoe immediately after insertion. Find articles by Mohammed Idris.


Whereas, distal shoe space maintainer was dlstal on the mandibular left side Figure 2. Agri and Aquaculture Journals Dr. Abstract Preservation of the primary dentition until the normal time of exfoliation is one of the most important factor involved in preventive and interceptive dentistry. J Clin Pediatr Dent. Can’t read the image?

Modified Distal Shoe Appliance for Premature Loss of Multiple Deciduous Molars: A Case Report

Conventional design poses a variety of problems in cases of multiple loss of lower primary molars prior to eruption of first permanent molar. Conclusion The modified distal shoe appliance is time efficient, more stable, better accepted by the child and meets all the criteria for proper space maintainer.

Dent Clin N Amer. Author information Article notes Copyright and License information Disclaimer.

Clinical examination revealed deep carious lesion and IOPA radiograph showed pulpal involvement in relation to lower right and left primary first and second molars and upper left primary first molar. Eur Arch Pediatr Dent. Photograph showing fracture of both maxillary central incisors. National Center for Biotechnology InformationU. Find articles by Navin H.

Distal shoe space maintainer maintains the space for the eruption of second premolar and at the same time guide the eruption of permanent first molar. This article has been cited by other articles in PMC. Modification of distal shoe space maintainer was advocated shoee of inadequate abutments caused due to multiple loss of deciduous molars on right side.

The appliance traditionally suggested as the treatment of choice is the distal shoe space maintainer [ 4 ]. The primary second molar served as a guide on the working model for calculating the horizontal length of distal extension.

Radiograph showing obstruction of second premolar from eruption by the intra-alveolar extension. Find articles by Pradeep Christopher. Premature eruption of the premolars. Discussion Dental caries is one of the most common reason for the premature loss of primary teeth [ 1 ].


The distal shoe space maintainer chairside fabrication and clinical performance.

But this type of design has certain disadvantages such dista non-functional, difficulty in fabrication and cannot be given in uncooperative patients [ 7 ]. Periodic recall appointment was advised to monitor the eruption of mandibular left second premolar. Failure of the tooth germ to develop as a sequelae to periapical or inter-radicular infection of the primary tooth is uncommon but has been reported [ 10 ].

The distal shoe space maintainer remains an acceptable standard of care, with an extension subgingivally to a location mesial to the unerupted first permanent molar [ 5 ]. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Space Maintainers: Types Of Space Maintainers

October 28, Citation: Showing post-operative photograph of the mandibular arch 1. J Am Dent Assoc. The present case showed hypoplastic crown with brownish discoloration of enamel, severe pitting and irregularities of crown in relation to right second premolar. Modified distal shoe appliance for the loss of a primary second molar: Also gingival extension of the distal shoe may damage the developing tooth bud, which may cause displacement of tooth [ 12 ].

For this a regular follow-up should be stressed after placement of space maintainer. Find articles by Niharika Rai. The modified distal shoe appliance offered several advantages over the conventional appliance such as increased stability and strength, fixed appliance, less chairside time and less co-operation of the patient. October 20, ; Published Date: Due to lack of regular follow-up, in this case, space maintainer remained for the longer time in the mouth, causing hindrance in the eruption of second premolar from its intragingival extension.