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Abstract

Primary teeth serve many critical functions in the growing child: they allow for proper chewing function for appropriate diet and nutrition, help in speech production and development, promote self-esteem, and importantly preserve space for eruption of the succedaneous permanent dentition. Premature loss of a primary molar can cause a loss of arch perimeter and negatively impact the normal eruption path of premolars. Space maintenance is an approach to minimize or prevent untoward consequences after unavoidable loss of a primary molar. Several types of space maintainers can be used to preserve arch length, including fixed unilateral space maintainers, such as the band and loop, crown and loop, or distal shoe; and fixed bilateral appliances, such as the transpalatal arch, Nance appliance, and lower lingual holding arch. This guide to space maintenance describes the background, considerations for use, indications for different appliances, and describes steps involved in chairside and laboratory fabrication of common space maintainer appliances.

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