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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It is a valuable asset disatl the paediatric dentist faced with the decision that a primary first and second molar needs to be extracted prior to the eruption of the first permanent molar. To avoid these problems and reduce the need for prolonged orthodontic treatment, space maintainer should be advised.

In the present case, modification of distal shoe space maintainer was advocated because of inadequate abutments caused due to multiple loss of deciduous molars. Articles from Journal of Clinical and Diagnostic Research: Syoe it is required to modify the conventional designs for comfort, co-operation and success in different paediatric patients [ 3 ].

Photograph after restoration of central incisors.

However poor retention and patient compliance mqintainer the major drawbacks with this appliance [ 6 ]. In the present case, several advantages such as increased stability and strength, less chairside time and less co-operation of the patient were shown by the modified distal shoe appliance over the conventional appliance.

Thus, a short term modified bilateral design of the distal shoe appliance was planned whose duration of use was subjected to closely watched eruption of permanent mandibular incisors both radiographically and clinically. Home Publications Conferences Register Contact. Guidelines Upcoming Special Issues. National Center for Biotechnology InformationU. A cost-effective maintainer for primary spqce molars.

Conventional design of distal shoe space maintainer was not advocated in the present case due to multiple loss of lower primarymolars. Also gingival extension of the distal shoe may damage the developing tooth bud, which may cause displacement of tooth [ 12 ].


After removal of the space maintainer, patient was regularly followed and it was found that on this side second premolar had completely erupted after one year eight months, although on the contralateral side it was present when first time patient reported to us.

Various treatment options have been suggested in case of premature loss of second primary molar before eruption of first permanent molar [ 89 ]. September 19, ; Accepted Date: Select your language of interest to view the total content in your interested language. Find articles by Niharika Rai.

In the present case, the right first and second premolars showed hardly any root development showing signs of complete stoppage of root development. Radiograph showing obstruction of second premolar from eruption by the intra-alveolar extension. The erupted lower right first and second premolar were hypoplastic with brownish discoloration of enamel, severe maintaine and irregularities of crown and hardly showed any root development.

The distal shoe space maintainer chairside fabrication and clinical performance.

A space maintainer that will guide the permanent first molar into its normal maijtainer was indicated. As it is a bilateral appliance it is possible for it to create hindrance in the path of eruption of permanent mandibular incisors. A 10 year female child reported to the dental department with the chief complaint of pain in the upper front teeth. Find articles by Navin H.

Unsupervised Distal Shoe Appliance: A Case Report | OMICS International

October 28, Citation: As there was premature eruption of right first and second premolar prior disal the eruption of right first permanent molar and the first permanent molar showed signs of eruption, the modified distal shoe appliance was removed before the eruption of right first permanent molar. Modified distal shoe appliance for the loss of a primary second molar: Can’t read the image? Considering the age of the child, position and developmental stage of both mandibular left premolars, it was decided to remove mandibular left first primary molar along with distal shoe appliance.


This case report describes an innovative modification of distal shoe appliance in cases of premature loss of multiple deciduous molars. Slace development of a permanent tooth.

Support Center Support Center. Discussion Dental caries is one of the most common reason for the premature loss of primary teeth [ 1 maaintainer. Other adverse effects of pre-mature extraction of primary molar are mesial migration of first permanent molar, increased overbite, increased crowding, impaction, occlusal impairment, arch asymmetry and disruption of eruption sequence.

J Clin Diagn Res. But this type of design has certain disadvantages such as non-functional, difficulty in dital and cannot be given in uncooperative patients [ 7 ].

Find articles by Mohammed Idris. Arrested permanent tooth development maintained been reported as a consequence of pulpal infection of carious primary teeth [ 9 ]. Pharmaceutical Sciences Journals Ann Jose ankara escort. Premature loss of the primary second molar prior to the eruption of the permanent first molar is often a challenging problem to the dentist in managing the developing dentition.

Anteriorly the wire component was made like lingual holding spzce and posteriorly the wire component like distal shoe. Other contraindications includes blood maimtainer, juvenile diabetes, low resistance to infection, congenital heart disease, history of rheumatic fever and generalized debilitation [ 79 ].

This was due to the lack of regular radiographic examination and follow-up. Author information Article notes Copyright and License information Disclaimer. The primary second molar served as a guide on the working model for calculating the horizontal length of distal extension.