Modified Intra-alveolar appliance — Case report

Arch space/ Tooth size discrepancy occurs whenever there is a early loss of the deciduous molars which eventually leads to malocclusion. Prevention of this discrepancy has always been a challenge for a pediatric dentist. This case report describes modified bilateral distal shoe appliance fabricated due to inadequate abutment support.

Willet’s distal shoe appliance for early loss of second deciduous molar: A case report with 2 year follow up

The possibilities for space loss are even higher when second primary molars are lost early because they serve as a buttress for the eruption of first permanent molar. Distal shoe space maintainer is indicated in such type of cases. It is otherwise known as intra-alveolar appliance. In this article, we report the successful use of the distal shoe space maintainer in a 4yr old child.

Opciones de tratamiento en un paciente con pérdida prematura de segundos molares primarios: zapato distal modificado / Treatment Options in a Patient with Primary Second Molar Premature Loss: Modified Distal Shoe Space Maintainer

RESUMEN. Antecedentes: La pérdida prematura de un molar primario conlleva a malposición de los dientes contiguos y del sucesor permanente. El efecto depende de las fuerzas que actúan sobre el diente, que están condicionadas a su vez por el estado de erupción del primer molar permanente. Propósito: Describir una opción de tratamiento para la pérdida prematura de segundos molares primarios hasta la erupción de los primeros molares permanentes. Descripción del caso: El caso clínico presentado involucra la rehabilitación oral de un niño de 5 años de edad que presentaba pérdida prematura de los segundos molares primarios. Se decidió colocar un mantenedor de espacio tipo zapato distal modificado. Se realizaron controles trimestrales y, cuando erupcionaron los primeros molares permanentes, aproximadamente a los nueve meses, se les utilizó como pilares para confeccionar el arco lingual. Conclusiones: El tratamiento propuesto mostró resultados satisfactorios en el mantenimiento del espacio hasta la erupción de los primeros molares permanentes.ABSTRACT. Background: The premature loss of a deciduous molar leads to malposition of adjacent teeth and the permanent successor. The effect depends on the forces acting on the tooth, which are conditioned at the same time by the grade of eruption of the first permanent molar. Purpose: To describe a treatment option for primary second molar premature loss until first permanent molars erupt. Case description: This clinical case involves the oral rehabilitation of a 5-year-old boy who lost prematurely his primary second molars. The decision was to place a modified distal shoe space maintainer. Controls were performed every three months and when the first permanent molars erupted, approximately nine months later they were used as pillars, to make the lingual arch. Conclusions: The treatment used showed satisfactory results in maintaining the space until permanent first molars erupted.

Utilización de Zapatilla Distal debido a pérdida prematura de una segunda molar temporal: Reporte de caso

The maintenance of the temporal dentition until its natural replacement is very important, due to the fact that the primary pieces are the ones in charge to secure the permanent pieces’ space, in addition to guide the eruption process. The premature loss of temporal pieces could lead to: decrease in arch perimeter, desviation of the mid line, malocclusions, ectopic eruptions, crowding, impact and/ or extrusion of permanent pieces, abnormalities in the mucous and acquisition of parafunctional habits. If early second molars extracted, can be used as a distal shoe maintainer; which is a complicated and sensitive technique, plus it is not suitable for all patients.This case report describes the use of a distal shoe in the inferior quadrant of a 5 years old child, the technique used, advantages and disadvantages of the appliance, also monitoring for one year.