An intra alveolar type of space maintainer also known as willets distal shoe was given. A 12 month follow up was taken. Conclusion: In. Space maintainers are appliances used to maintain space or regain .. The only treatment alternative to the distal shoe space maintainer is a. Distal shoe space maintainer is a valuable part of the Paediatric Dentist’s armamentarium in those cases where the second primary molar is.

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In the present case reported here, there was a premature eruption of right first and second premolars prior to the eruption of right permanent first molar. Sheo Report Open Access. Arrested development of a permanent tooth. All the permanent incisors, first molars, maxillary first premolars and mandibular right second premolar were erupted.

Conventional design poses a variety of problems in cases of multiple loss of lower primary molars prior to eruption of first permanent molar.

The appliance traditionally suggested as the treatment of choice is the distal shoe space maintainer [ 4 ]. Developmental arrest of permanent tooth germs following pulpal infection of deciduous teeth.

Prasanna Kumar Bhat1 Navin H. Unfortunately patient did not turn up for follow up treatment and reported back to the department six months later with a swelling in the lower right back teeth region. The purpose of this case report was to present a side effect in a case of unsupervised distal shoe space maintainer which was placed in a child and not followed regularly.

An erupting tooth adjacent toan edentulous area has a greater potential for space loss than fully erupted ones, indicating that clinical intervention should be considered [ 3 ].

The vertical depth of intra-alveolar projection was calculated radiographically, and a cut was made in the cast and wire components were adapted using gauge wire. Conventional design of distal shoe space maintainer was not advocated in the present case due to multiple loss of lower primarymolars. Open in a separate window. Also gingival extension of the distal shoe may damage the developing tooth bud, which may cause displacement of tooth [ 12 ].


Distal shoe space maintainer is advised in case of early loss of second primary molar before eruption of first permanent molar. The distal shoe space maintainer remains an acceptable standard of care, with an extension subgingivally to a location mesial to the unerupted first permanent molar [ 5 ]. It was then decided to remove the modified distal shoe appliance and the patient was closely monitored during the recall visits.

Unsupervised Distal Shoe Appliance: A Case Report | OMICS International

In the present case, the right first and second premolars showed hardly any root development showing signs of complete stoppage of root development. In the maxillary central incisors pulp treatment were done followed by composite build-up in maxillary right central incisor and fragment reattachment in maxillary left central incisor Figure 4.

Can’t read the image? The modified distal shoe appliance is time efficient, more stable, better accepted by the child and meets all the criteria for proper space maintainer. The solder was allowed to flow between the buccal and lingual wire to create a guide plate on the right side of the posterior wire component. The recall visits were planned after every two months to check the condition of the modified distal shoe appliance, supporting teeth and status of eruption of lower incisors.

Anteriorly the wire component was made like lingual holding arch and posteriorly the wire component like distal shoe. Thus, a short term modified bilateral design of the distal shoe appliance was planned whose duration of use was subjected to closely watched eruption of permanent mandibular incisors both radiographically and clinically. In the present case, modification of distal shoe space maintainer was advocated because of inadequate abutments caused due to multiple loss of deciduous molars.

Other adverse effects of pre-mature extraction of primary molar are mesial migration of first permanent molar, increased overbite, increased crowding, impaction, occlusal impairment, arch asymmetry and disruption of eruption sequence.


Unsupervised Distal Shoe Appliance: A Case Report

Periodic recall appointment maintainee advised to monitor the eruption of mandibular left second premolar. For this a regular follow-up should be stressed after placement of space maintainer. Extraction and removal of distal shoe space maintainer was done under local anaesthesia lidocaine with adrenaline 1: Various treatment options have been suggested in case of premature loss of second primary molar before eruption of first permanent molar [ 89 ].

Pediatr Dent Care 1: Photograph showing disgal shoe on the left and erupting second premolar on the right. Published online Aug Arrested permanent tooth development has been reported as a consequence of pulpal infection of carious primary teeth [ 9 ]. Treatment planning for the distal shoe space maintainer. This sgoe has been cited by other articles in PMC.

Modified Distal Shoe Appliance for Premature Loss of Multiple Deciduous Molars: A Case Report

The wire components were soldered to bands on both the sides. Find articles by Navin H.

J Am Dent Assoc. But this type of design has certain disadvantages such as non-functional, difficulty in fabrication and cannot be given in uncooperative patients [ 7 ].

Band and loop space maintainer – made easy. This appliance s;ace difficult to place into proper position passively contracting the mesial surface of the erupting permanent maaintainer molar while extending only 1mm below the mesial marginal ridge [ 911 ]. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Home Publications Conferences Register Contact. Find articles by Niharika Rai.