ISSN 0975-8437 INTERNATIONAL JOURNAL OF DENTAL CLINICS 2011:3(1):117

INTERNATIONAL JOURNAL OF DENTAL CLINICS VOLUME 3 ISSUE 1 JANUARY-MARCH 2011 117

A Simple Modification of Fixed Space Maintainers for Replacement of An Avulsed

maxillary Primary Central Incisor Ravi.B. Patil, Rachappa.M.M

Abstract

Fixed space maintainers are fixed appliances used to maintain space so as to guide the unerupted

tooth into proper position in the arch. Fixed space maintainers with acrylic extension may cause food

accumulation under the acrylic extension and cause tissue inflammation. This paper reports a simple

modification of fixed space maintainer in a three and half year old boy.

Key Words: Space Maintainers;Primary Teeth;Incisors;Fracture

Received on: 25/10/2010 Accepted on: 22/12/2010

Introduction

Traumatic injuries to primary teeth are

common, especially 18 -30 months children are

very prone to accidents, and in particular

maxillary anterior teeth are more susceptible for

injuries, with avulsion of primary teeth is around

9-12%.(1) Early loss of maxillary incisors can

cause psychological, aesthetic and functional

problem due to development of tongue thrusting

habit in edentulous space.(2) In the present case

a simple modification of fixed space maintainer

was discussed.

Case Report

A three and half years old boy reported

to our dental office with complaint of unpleasant

look and alteration in speech. On examination it

was found 51 was avulsed two months back and

52 appears to be tilted (Fig1). On radiographic

examination, a rotated 11 with no retained root

segments of 51 were found. Preformed stainless

steel orthodontic bands were adapted to the 55

and 65 followed by alginate impressions of

upper and lower arches. 19 gauge stainless steel

wire was adapted on the lingual surfaces of

maxillary teeth without interfering the occlusion

and then soldered to the bands.

Stainless steel wire was roughened at

the 51 area for better retention. Composite shade

was selected and composite build up was done to

replace the 51. Finishing and polishing was done

and finally the modified fixed anterior space

maintainer was cemented with luting glass

ionomer cement (Fig2). Patient was recalled for

check up every three months.

Figure 1 Preop Figure 2 space maintainer

Discussion

Fixed space maintainers with acrylic

extension may cause food accumulation under

the acrylic extension and cause tissue

inflammation.(2) Fixed space maintainers with

proper design are less damaging to the oral

tissues and more appropriate for long periods.(3)

Modification of the fixed space maintainer was

chosen in this case because of the long duration

of the space maintainer required. Composite

build up was done because it provided the best

color match. Central incisor shaped build up was

done with neatly polished cervical area to

minimize the food accumulation and subsequent

soft tissue inflammation.

In conclusion a simple modification of

this type can easily reduce the disadvantages of

fixed space maintainers and reduce patient

discomfort there by increasing the durability of

the space maintainers. Authors Affiliations: 1. Dr. Ravi.B.Patil, M.D.S,

Associate Professor, Vinayaka Misssions Shankarachariyar Dental College, Salem, Tamilnadu,

2. Dr. Rachappa. M.M, M.D.S., Senior Lecturer, Dept.

Pedodontics, K.M.Shah Dental College, Vadodara,

India.

References 1. Andreasen J, Ravn J. Epidemiology of traumatic

dental injuries to primary and permanent teeth in

a Danish population sample. International Journal

of Oral Surgery1972;1(5):235-9.

2. Avsar A, Topaloglu B. Traumatic tooth injuries to primary teeth of children aged 03 years. Dental Traumatology 2009;25(3):323-7.

3. Qudeimat M, Fayle S. The longevity of space maintainers: a retrospective study. Pediatric

Dentistry 1998;20(4):267-72.

Address for correspondence

Dr. Ravi.B.Patil, M.D.S,

Associate Professor,

V.M.S Dental College, Salem,

Tamilnadu, India.

E mail: drpats72@yahoo.com

Source of Funding: Nil Conflict of Interest: NIL

CASE REPORT