Assessment of Periodontal Parameters Following the Use of Fixed and Removable Space Maintainers in 6-12-year Olds

Comparative evaluation of the clinical success of 3D-printed space maintainers and band-loop space maintainers

BACKGROUND

Exploring the integration of 3D-printing technology in space maintainer (SM) manufacturing could offer innovative solutions and insights for enhancing SMs.

AIM

To compare the clinical success, retention, and periodontal effect of traditional band-loop (TBL) SMs with 3D-printed SMs.

DESIGN

Seventy children (mean age: 6.99 ± 1.18) were divided into two groups. Laser sintering (LS) group (n = 34): Patients were scanned with an intraoral scanner. SMs were produced with LS 3D-printing method from a titanium-based metal powder. T group (n = 36): Impressions were taken with alginate. SMs were produced by adjusting the bands and soldering the wires on the model. The retention and effects on oral hygiene of the SMs were evaluated at the sixth month. Preference for impression technique was assessed by a five-question survey.

RESULTS

Thirty-eight percent of T SMs and 66% of LS SMs failed (p = .007). The mean survival time was significantly higher in the T group (p = .035). No difference was found between the initial and control full-mouth Gingival Index (GI) and Plaque Index (PI) values of the two groups. Both groups had increased GI/PI values in abutment teeth. Patients in the LS group interpreted their impression experience more positively.

CONCLUSION

It is important to provide oral hygiene education before applying fixed SMs and utilize more digital workflow in paediatric dentistry.

Longevity of Aesthetic Fixed Space Maintainers in the Anterior Area of the Pediatric Dental Patient

Space maintenance for children at very early ages in primary molars or posterior sectors is widely used and the scientific evidence is clear as to its indications. In the anterior sectors there are doubts as to whether there is a loss of space and its use is usually accompanied by aesthetic, phonatory requirements or the completion of certain habits. In this type of aesthetic anterior maintainer, there are many medium and long-term complications that can occur.

PURPOSE

To evaluate the factors determining possible complications capable of reducing the longevity of aesthetic fixed space maintainers placed due to premature loss of temporary upper anterior teeth.

METHODS

Data were collected on 100 patients of 1-5 years of age requiring fixed space maintainer placement in the upper anterior area due to caries or traumatisms.

RESULTS

Complications were recorded in the form of resin tooth fracture (in 41% of the cases), welding fracture (16%), detachments (28%), gingivitis (26%) and root resorptions (8%). Space maintainer placement in younger children (12-24 months of age) was associated with a significantly greater incidence of root resorptions (p < 0.05).

CONCLUSIONS

Within the limits of the present study, it is concluded that fixed space maintainers would be a good treatment option in patients with prematurely missing anterior teeth, though the use of temporary first molars as abutments could imply a greater risk of failure, with a lesser incidence of root resorptions. Periodic checks and adequate measures of hygiene are essential.

Digitainers-Digital Space Maintainers: A Review

To summarize the limitations of commonly used space maintainers (SMs) and provide an insight into the field's technological advances to overcome them, this review was conducted. With the rapid advancement of digital technologies, there is always something new to learn while also redefining the current fads. Digital workflow is not a new concept in dentistry, but it has only just begun to be used in pediatric dentistry. The curiosity to explore has led to the development of digital devices as SMs. They appear potential for usage in children because of their impressive advantages of precision, comfort, and a time-saving approach. This workflow helps lessen fear and improve children's cooperation and enthusiasm for dental appointments by cutting down on chairside time and shortening procedures.

How to cite this article: Dhanotra KGS, Bhatia R. Digitainers—Digital Space Maintainers: A Review. Int J Clin Pediatr Dent 2021;14(S-1):S69–S75.

Short-term efficacy of vacuum-formed maintainer for deciduous second molar space maintenance in the mixed dentition: A single-centre, randomized controlled clinical trial

OBJECTIVE

To compare the efficacy of vacuum-formed and banded space maintainers for deciduous second molar space maintenance during the mixed dentition.

SETTING AND SAMPLE POPULATION

The study sample comprised thirty children in the mixed dentition (age range, 5.9 to 9.8 years) with early loss of at least one deciduous second molar.

METHODS

This was a parallel-group, randomized, active-controlled clinical trial. Patients were randomly allocated to space maintenance performed with vacuum-formed or banded space maintainers with a 1:1 allocation ratio. The main outcome was any change in mesiodistal width of the extraction space. Secondary outcomes included the lingual rolling or axial rotation of the permanent first molar adjacent to the extraction site and extrusion of the antagonist tooth. Dental casts were obtained before appliance installation (T0), after 3 months (T1) and after 6 months (T2). Digital dental casts were measured using Dolphin 3D software. Chi-square, t test or Mann-Whitney and ANOVA or Friedman test were used for intra- and intergroup comparisons (P < .05).

RESULTS

Baseline characteristics were similar between groups except for chronological age. Statistically, but not clinically significant space loss (mean, 0.32 mm; SD, ± 0.39) occurred with the vacuum-formed space maintainer only at the first trimester (T0-T1). Lingual rolling and axial rotation of the first permanent molar were not significant, as well as extrusion of the antagonist tooth.

CONCLUSIONS

The results of this study suggested that both tested devices were effective in maintaining space after early extraction of the deciduous second molar over a period of 6 months.