Premature loss of primary teeth in children may lead to changes to the permanent dentition including malocclusion and dental arch issues due to drifting teeth. Dental space maintainers (SMs) are commonly used to preserve alignment of the existing dental arch, and to preserve space for unerupted teeth. Broadly, there are two categories of SMs: fixed, which are cemented to one or more teeth, and removable, which are not cemented and can be taken out of the oral cavity. They can be constructed of different materials such as stainless steel wire, or glass fiber-reinforced composite resin (GFRCR). They can be placed on the mandibular or maxillary arch. Examples of SMs include band and loop, lingual arch, palatal arch, and crown-loop.
Given suggestions by dental associations for their use among children for primary teeth loss, it is important to understand the clinical evidence and costs associated with SMs, as well as to look to evidence-based guidelines on appropriate use. Potential benefits include reduction of crowding, ectopic eruption, crossbite, excessive overbite and overjet, and poor molar relationship. However, SMs can increase plaque accumulation, decrease periodontal health, and increase oral microflora.
The purpose of this review is to examine the clinical effectiveness, cost-effectiveness, and guideline recommendations surrounding the types and use of SMs.
Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that the Canadian Agency for Drugs and Technologies in Health (CADTH) could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along with other types of information and health care considerations. The information included in this response is not intended to replace professional medical advice, nor should it be construed as a recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality evidence does not necessarily mean a lack of effectiveness particularly in the case of new and emerging health technologies, for which little information can be found, but which may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that effect. CADTH is not liable for any loss or damages resulting from use of the information in the report.
