Clinical Success of Fiber-reinforced Composite Resin as a Space Maintainer.

INTRODUCTION: The early loss of deciduous molars is a frequently encountered problem in dentistry. Various space maintainer designs were developed to prevent the loss of the space. The aim of this study was to evaluate long-term clinical performance and survival rates of fiber-reinforced composite resin (FRCR) as a space maintainer clinically. MATERIALS AND METHODS: This study was designed on 44 children who had early missed deciduous molars. Space maintainers were prepared on plaster models of patients and fixed directly to the adjacent teeth. Survival rate and whether it causes any damage to adjacent teeth were examined clinically and radio-graphically for 24 months or until failure. Kaplan-Meier survival analysis was used for the statistical analyses. RESULTS: Overall, 16.2% of space maintainers were dislodged and accepted to be failed at the end of 12 months. At the 24-month control, 52.2% success was stated with the FRCR space maintainer and because of permanent tooth eruption, 31.8% of space maintainer were taken out. The mean duration of space maintainers was measured to be 14.8 ± 3.48 months. There was no statistical significance between survival time and gender, tooth number, localization, and measured space (p > 0.05). CONCLUSION: After all 24 months follow-up, as well as esthetic properties of FRCR space maintainer, their applicability in a single seance and strength against the forces are determined as the advantages of the technique. CLINICAL SIGNIFICANCE: The FRCR space maintainers can be thought of as alternatives to metal space maintainers.

E-space preservation.

OBJECTIVE: To determine the relationship of E-space preservation with lingual holding arches to mandibular permanent second molar impaction. METHODS: Two hundred consecutively treated patients undergoing nonextraction treatment for incisor crowding were entered into the study. Lower incisor crowding was assessed by the Little Irregularity Index. Treatment involved E-space preservation via a passive lingual arch placed prior to exfoliation of the second primary molar. Panoramic and cephalometric radiographs were analyzed for any significant relationship of mandibular permanent second molar impaction relative to molar angulation, spacing, growth pattern, and skeletal relationships. RESULTS: Twenty-nine patients had at least one impacted second molar (14.5%). Of a possible 400 mandibular second molars, 34 were determined to be impacted (8.5%). Only the mandibular first molar-second molar angulation was found to be significant (P < .001). Pretreatment intermolar angulation of 24 degrees had a positive predictive value of 1. CONCLUSION: Impaction of permanent second mandibular molars in patients undergoing nonextraction via E-space preservation with a passive lingual arch is 10 to 20 times more prevalent than that observed in the general population. Risk of impaction is best predicted by the pretreatment intermolar angulation between first and second permanent mandibular molars.

Emergency orthodontic care.

Orthodontic appliances or parts of orthodontic appliances have caused problems from less severe like discomfort, ulcers and irritation of lips or cheeks to most severe problems like swallowing or aspiration of appliances or its parts. The type of appliances that have caused problems and their clinical management are discussed. Suggestions are made to try and avoid the problems that were encountered in the literature in patients undergoing orthodontic treatment.

Space maintenance.

OBJECTIVE: The use of a space maintainer appliance, or restoration of a carious primary tooth that can then act as a natural space maintainer, may potentially obviate the consequences of loss of arch length and the need for complex orthodontic treatment at a later stage. Nevertheless, all space maintainer appliances are plaque retentive and may predispose to dental caries and gingival inflammation. Space maintainer appliances may also impinge on the soft tissues, interfere with eruption of adjacent teeth, fracture, and become dislodged or lost. This review article provides a summary of the available evidence, and considers the indications for space maintenance. METHODS: Medline and Ovid Medline were scanned, and additionally a hand-search of non-listed peer-reviewed papers written in English was performed. A total of 16 pertinent papers published between 1987 and 2007 that satisfied the inclusion criteria were selected for discussion. CONCLUSIONS: There is limited evidence to recommend either for or against the use of space maintainers to prevent or reduce the severity of malocclusion in the permanent dentition. Decisions regarding the use of space maintainers should be guided by balancing the occlusal disturbance that may result if one is not used against the potential plaque accumulation and caries that the appliance may cause.