An 8-year-old child lost their mandibular primary molars early. Which space maintainer should be used?

Correct answer: B. Lingual holding arch

• A. The Nance appliance is used in the maxilla for bilateral space maintenance — not for mandibular molars.
• B. Correct. The lingual holding arch (LHA) is the appropriate bilateral space maintainer for the mandibular arch when primary molars are lost bilaterally before their permanent successors erupt. It maintains arch perimeter by connecting the permanent first molars via a lingual wire.
• C. The distal shoe is used for a recently lost mandibular second primary molar BEFORE the first permanent molar has erupted — it is a unilateral, fixed appliance.
• D. The transpalatal arch (TPA) is a maxillary appliance — not used in the mandible.