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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Especially primary molars are very important in development of occlusion and guidance for the eruption of permanent molar. Primary dentition plays a vital role in developing speech, mastication, aesthetic, prevention of bad oral habits and eruption of permanent teeth [1,2]. Find articles by Mohammed Idris. The erupted lower right first and second premolar were hypoplastic with brownish discoloration of enamel, severe pitting and irregularities of crown and distla showed any root development.

This appliance should be changed with band and loop space maintainer after eruption of permanent first molar to avoid any adverse effect on the second premolar, as seen in this case. Pulp therapy was carried out on lower left primary first and second molars and upper left primary first molar,followed by stainless steel crown.

The distal shoe space maintainer chairside fabrication and clinical performance.

Radiograph dietal obstruction of second premolar from eruption by the intra-alveolar extension. National Center for Biotechnology InformationU. Photograph showing fracture of both maxillary central incisors. Conventional design of distal shoe space maintainer was not advocated in the present case due to multiple loss of lower primarymolars. Photograph showing distal shoe on the left and erupting second premolar on the right. Published online Aug Modified distal shoe appliance, Premature loss of multiple deciduous molars.


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

Considering the age of the child, position and developmental stage of both mandibular left premolars, it was decided to remove mandibular left first primary molar along with distal shoe appliance. However poor retention and patient compliance are the major drawbacks with this appliance [ 6 ]. Visit for more related articles at Neonatal and Pediatric Medicine.

Intraoral periapical radiograph showing modified distal shoe ten months after insertion. One such appliance was presented by Willett called distal shoe space maintainer with distal extension which goes intra-gingivally to guide the eruption of permanent first molar [ 10 ]. The primary second molar served as a guide on the working model for calculating the horizontal length of distal extension.

Band adaptations were made on lower left second deciduous molar and lower right deciduous canine. 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

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 maintsiner 3 ].

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 ].

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. So it is required to modify the conventional designs for comfort, co-operation and success in different paediatric patients [ 3 ].


Showing post-operative photograph of the mandibular arch 1. J Clin Diagn Res. Guidelines Upcoming Special Issues. So the design of distal shoe was modified such that it is able to maintain mesiodistal dimension of the space without any compromise on the stability or cooperation of the patient.

Primary dentition plays a vital role in dlstal speech, mastication, aesthetic, prevention of bad oral habits and eruption of permanent teeth [ 12 ].

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.

The wire components were soldered to bands on both the sides. This case report describes an innovative modification of distal shoe dstal in cases of premature loss of multiple deciduous molars.

Intraoral periapical radiograph showing modified distal shoe immediately after insertion.

Premature eruption of the premolars. But this type of design has certain disadvantages such as non-functional, difficulty in fabrication and cannot be given in uncooperative patients [ 7 ]. In the present case, mwintainer advantages such as increased stability and strength, less chairside time and less co-operation of the patient were shown by the modified distal shoe appliance over the conventional appliance.

Treatment planning for the distal shoe space maintainer. Open in a separate window.