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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Pulp therapy was carried out on lower left primary first and second molars and upper left primary first molar,followed by stainless steel crown. Select your language of interest to view the total content in your interested language.

The erupted lower right first and second premolar were hypoplastic with brownish discoloration of enamel, severe pitting and irregularities of crown and hardly showed any root development.

Unsupervised Distal Shoe Appliance: A Case Report | OMICS International

Distal shoe space maintainer is advised in case of early loss of second primary molar before eruption of first permanent molar. Intraoral periapical radiograph showing modified distal shoe ten months after insertion. Stability of the appliance would have been a major issue inthis case, if we had given distal shoe space maintainer by banding canine. Extraction and removal of distal xistal space maintainer was done under local anaesthesia lidocaine with adrenaline 1: Especially primary molars are very important in development of occlusion and guidance for the eruption of permanent molar.

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This article has been cited by other articles in PMC. National Center for Biotechnology InformationU. Considering the age of the dsital, position and developmental stage of both mandibular left premolars, it was decided to remove mandibular left first primary molar along with distal shoe appliance.

Conventional design poses various limitations in cases of premature loss of multiple deciduous molars. Author information Article notes Copyright and License information Disclaimer. Find articles by Prasanna Kumar Bhat. 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 mantainer when first time patient reported to us.


The space maintainer was well-accepted by the child and his parents and was optimistic for the future spave his dentition.

In the present case, modification of distal shoe space maintainer was advocated because of inadequate abutments caused due to multiple loss of deciduous molars.

Another disadvantage of this appliance is that, the gingival tissue disfal the intra-alveolar extension never becomes completely lined with epithelium, thus maintaining an open wound in the oral cavity [ 13 ].

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 mmaintainer sequence [ 2 – distzl ].

Bilateral design of distal shoe was planned for unilateral loss of deciduous molars. But this type of design has certain disadvantages such as non-functional, difficulty in fabrication and cannot be given in uncooperative patients [ 7 ].

Ann Jose ankara escort. Also gingival extension of the distal shoe may damage the developing tooth bud, which may cause displacement of tooth [ 12 ]. One such appliance was presented by Willett xhoe distal shoe space maintainer with distal extension which goes intra-gingivally to guide the eruption of permanent first molar [ 10 ]. A cost-effective maintainer for primary second molars.

Unsupervised Distal Shoe Appliance: A Case Report

Can’t read the image? All the permanent incisors, first molars, maxillary first premolars and mandibular right second premolar were erupted.

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. Pharmaceutical Sciences Journals Ann Jose ankara escort. It is a valuable asset to 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.


Access cavity preparation was carried out on lower right primary first and second molars and closed dressing was given.

An erupting tooth adjacent toan edentulous area has a greater potential for space sspace than fully erupted ones, indicating that clinical intervention should be considered [ 3 ]. October 20, ; Published Date: Unfortunately patient did not turn up for follow up treatment and reported back to the department six months later with a swelling in the lower right back teeth region. However it appeared that intragingival extension of distal shoe appliance was obstructing the eruption of mandibular second premolar Figure 3.

So the design of distal shoe was modified such that it is able to maintain mesiodistal dimension of the space without any compromise on the stability or cooperation of the patient. For this a regular follow-up should be stressed after placement of space maintainer.

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Space Maintainers: Types Of Space Maintainers

Primary dentition plays a vital role in developing speech, mastication, aesthetic, prevention of bad oral habits and eruption of permanent teeth [1,2].

This case report describes an innovative modification of distal shoe appliance in cases of premature loss of multiple deciduous molars. As it is a bilateral appliance it is possible for it to create hindrance in the path of eruption of permanent mandibular incisors. In the present case reported here, there was a premature eruption of right first and second premolars prior to the eruption of right permanent first molar. The present case showed hypoplastic crown with brownish discoloration of enamel, severe pitting and irregularities of crown sjoe relation to right second premolar.

The wire components were soldered to bands on both the sides.

Whereas, distal shoe space maintainer was present on the mandibular left side Figure 2.