Pediatric Dentistry · patient case question
Which appliance is indicated for the space left by tooth L, and how is it classified?
Patient case: Premature loss of primary molars in the mixed dentition
Patient: Female, 6 years old
Chief Complaint: Referred after two primary molars were extracted because of gross caries.
Background: Tooth T (the mandibular right second primary molar) and tooth L (the mandibular left first primary molar) have both been lost prematurely.
Current Findings: The permanent mandibular first molars have not yet erupted. The permanent lateral incisors are unerupted. No crowding is evident in the anterior segment. She is otherwise healthy.
Show answer and explanation
Correct answer: C. A band and loop — fixed and unilateral
- A. The band and loop is cemented in place, not removable. Removable maintainers depend on patient compliance and are used in different circumstances.
- B. The lower lingual holding arch is bilateral and requires the permanent incisors to have erupted; it is used for BILATERAL mandibular space maintenance.
- C. CORRECT. The band and loop is a FIXED, UNILATERAL, non-functional space maintainer. It is banded to the tooth distal to the space with a wire loop contacting the tooth mesial to it, holding the mesiodistal dimension open. It is the standard choice after loss of a single primary molar.
- D. The Nance holding arch is a bilateral MAXILLARY appliance with an acrylic button resting on the anterior palate. This patient's loss is mandibular.
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