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.
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